Influenza Vaccination Distribution and Coverage, United ... · October 26, 2011 National Center for...
Transcript of Influenza Vaccination Distribution and Coverage, United ... · October 26, 2011 National Center for...
Influenza Vaccination Distribution and Coverage United States 2010-11 and 2011-12 Seasons
Presented by James A Singleton MS
Assessment Branch ISDNCIRDCDC
Contributors Lina Balluz Carolyn Bridges Leah Bryan Helen Ding Gary Euler
Carolyn Furlow Amparo Gonzalez-Feliciano Erin Kennedy Liz Monsell Peng-Jun Lu Tammy Santibanez Raymond Strikas Cindy Weinbaum
Meeting of the ACIP October 26 2011
National Center for Immunization and Respiratory Diseases
Immunization Services Division 1
2010-11 Influenza Season Challenges
bull First ldquopost-pandemicrdquo season
ndash High seasonal vaccine coverage in 2009-10 driven by pandemic
ndash Public interest in vaccination
bull First season with universal flu vaccination recommendations (added group was 18-49 healthy non household contactsmdash15 of US population)
bull New andor expanded venues for vaccinationmdash(schools and pharmacies)
bull Unprecedented vaccine supply
2
Cu
mu
lati
ve
nu
mb
er
of
do
ses
dis
trib
ute
d
in m
illi
on
s
1582m
0
20
40
60
80
100
120
140
160
180
Cumulative doses of influenza vaccines distributed by month 2004-05 -- 2010-11 seasons US
2010-11
2009-10
2008-09
2007-08
2006-07
2005-06
2004-05
July
wk
1
wk
2
wk
3
wk
4
Au
gu
st w
k 1
wk
2
wk
3
wk
4
Sep
tem
ber
wk
1
wk
2
wk
3
wk
4
Oct
ob
er w
k 1
wk
2
wk
3
wk
4
No
vem
ber
wk
1
wk
2
wk
3
wk
4
Dec
emb
er w
k 1
wk
2
wk
3
wk
4
Jan
ua
ry w
k 1
wk
2
wk
3
wk
4
Feb
rua
ry w
k 1
wk
2
wk
3
wk
4
Month
Source Biologics data 3
2010-11 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2010 and April 2011
bull National Flu Survey (NFS) November 2010 and March 2011
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
4
2010-11 Season Vaccination Data Methods bull Final estimates from NIS interviews Sept 2010-June 2011
(6mo-17yrs n=116799) and BRFSS (ge18yrs n=377569)copyndash Online report at httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
ndash Updates interim estimates from MMWR June 10 2011 Vol 60 No
22 Pg 737 - 743
ndash Trends in adults for BRFSS 2007-08 through 2010-11 seasons
bull April 2011 internet panel surveys
ndash Healthcare personnel (n=1931)
bull MMWR August 19 2011 Vol 60 No 32 Pg 1073 - 1077
ndash Pregnant women (n=1457)
bull MMWR August 19 2011 Vol 60 No 32 Pg 1078 - 1082
bull Place of flu vaccination data from BRFSS
ndash January-March 2011 data from 46 states and District of Columbia
ndash MMWR June 17 2011 Vol 60 No 23 Pg 781-785 5
Influenza Vaccination Coverage by Month 2009-10 and 2010-11 Seasons
Online at httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
00
100
200
300
400
500
600 A
UG
SE
P
OC
T
NO
V
DE
C
JAN
FE
B
MA
R
AP
R
MA
Y
Co
ve
rag
e (
)
Month
2010-11
2009-10 seasonal
2009-10 seasonal andor H1N1
00
100
200
300
400
500
600
AU
GS
EP
OC
TN
OV
DE
CJA
NF
EB
MA
RA
PR
MA
Y
Co
ve
rag
e (
)
Month
2010-11
2009-10 seasonal
2009-10 seasonal andor H1N1
Children 6 mo ndash 17 yrs Adults ge18 yrs
6
Influenza Vaccination (trivalent) Coverage by Age 2008-09 through 2010-11 Seasons
Group 2008-09
() 1
2009-10
() 2
2010-11
() 3
Overall (persons aged gt 6 mo) Not Available 412 430
Children 6 mos-17 years 291 437 510
Persons gt 18 yrs 402 404 405
Persons 18-49 yrs all 282 299 305
Persons 18-49 yrs high risk 387 382 390
Persons 50-64 yrs 459 450 445
Persons ge 65 yrs 736 696 666
1 BRFSS 2008-09 for adults child estimate from 2009 NHIS ages 6 mo ndash 18 years online at
httpwwwcdcgovvaccinesstats-survnhis2009-nhishtm
2 BRFSS and National 2009 H1N1 Flu Survey (NHFS) estimates 2009-10 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_0910estimateshtm
3 BRFSS and NIS estimates 2010-11 Online at httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
7
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
80
Most children 6-11 months on 1112010 need 2 doses to be fully vaccinated
From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians without
provider confirmation prior season vaccinations not ascertained
69 63
52
62 62 60 57 55 53
33
22
13 12 12 13 8 10 10
6-11 mo
V
acc
ina
ted
70
60
50
40
30
20
10
0
ge 1 dosescopyge2 dosescopy
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
Age on November 1 2010
8
Influenza Vaccination (trivalent) Coverage by RaceEthnicity 2008-09 through 2010-11 Seasons
Group 2008-09
() 1
2009-10
() 2
2010-11
() 3
Adults by Raceethnicity
White non-Hispanic 435 441 432
Black non-Hispanic 350 328 342
Hispanic 284 293 323
Children by Raceethnicity
White non-Hispanic Not Available 432 485
Black non-Hispanic Not Available 370 508
Hispanic Not Available 469 551
Statistically significant difference compared to non-Hispanic whites (plt005)
1 BRFSS 2008-09 for adults
2 BRFSS and National 2009 H1N1 Flu Survey estimates 2009-10 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_0910estimateshtm
3 BRFSS and NIS estimates 2010-11 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
9
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
10
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
11
Estimated Influenza Vaccination (trivalent) Coverage Healthcare Personnel
V
acc
ina
ted
90
80
70
60
50
42 44 45
53 53
56
62 64
HP 2020 target is 90 percent
40
30
20
10
0
NHIS
BRFSS
NHFS
Internet Panel
2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season
Estimates from the National Health Interview Survey (NHIS) Behavioral Risk Factor Surveillance System (BRFSS) National 2009
H1N1 Flu Survey (NHFS) and internet panel surveys (MMWR August 19 2011 60(32)1073-1077)
12
Estimated Influenza Vaccination (trivalent) Coverage Pregnant Women
80
70
60
50
40
30 27
19
21
21
25
26
36
51 51
27 32
27
51
32
49
HP 2020 target is 80 percent
V
acc
ina
ted
BRFSS Pregnant BRFSS Not Pregnant PRAMS (10 states) NHFS Internet Panel 20
10
0 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season Behavioral Risk Factor Surveillance (BRFSS) data from December interviews only for women 18-44 years pregnant or not pregnant when
interviewed Differences in influenza vaccination coverage between pregnant and not pregnant women were statistically significant
(plt005) only for the 2009-10 and 2010-11 seasons Other estimates for pregnant women from PRAMS (MMWR December 3 2010
59(47)1541-1545) NHFS (Ding et al Am J Obstetrics amp Gynecology June 2011 Supplement) and an internet panel survey (MMWR August
19 2011 60(32)1078-1082)
13
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 201160(23)781-785
Doctors officeHMO
HospitalED
Other clinichealth center
Health Department
Store
Workplace
Senior reccomm center
School
Other non-medical
0 10 20 30 40 50 60
18+ yrs
18-49
50-64
65+
40 18+ yrs
18 18+ yrs
17 18+ yrs
26 65+
52 65+
26 18-49
of vaccinated by place eg supermarket or drug store
BRFSS January-March 2011 data from 46 states and District of Columbia 14
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 2011
Doctorrsquos office is most important medical setting
Workplace and store important non-medical settings
Increase in store vaccination (184) compared to
1998-99 (5) and 2006-07 (7)
Increases in persons vaccinated since 2006-07
Doctorrsquos office 28 million (2006-07) to 37 million (2010-11)
Store 6 million (2006-07) to 17 million (2010-11)
vaccinated in non-medical settings higher for
whites (44) vs blacks (29) Hispanics (34)
Attended college (47) vs lt high school education (28)
15
Summary 44 million more seasonal (trivalent) influenza vaccine
doses distributed than in 2009-10 Coverage levels by census population estimates can provide estimates of doses
administered in the civilian non-institutionalized population
Moderate increase in childrenrsquos coverage since 2009
large increases since 2008
Similar coverage for adults as for 2009-10 trivalent
Coverage among adults ge65 years declining past two seasons
Racialethnic disparities among all adults persist
Non-Hispanic white adults significantly higher levels
Children nH-whites did not have higher coverage vs
other racialethnic groups in 2010-11
Wide variations among states
Maintained last seasonrsquos increases for pregnant women
and healthcare personnel 16
Limitations Self-reported vaccination not validated by medical records
Survey estimates may not be representative
BRFSS does not reach households with only cell phones (will do so next year)
Telephone survey response rates low
Representativeness of internet panel survey estimates needs further evaluation
Tracking trends by season complicated by multiple data sources
with different timeliness and possibly validity
Comparisons to 2009-10 season estimates complicated by unique
circumstances of pandemic and persons could have received
either 2009 H1N1 vaccine only seasonal vaccine only or both
17
Vaccination in the 2010-11 Influenza Season What did the US achieve
bull Despite the expected challenge of ldquoflu fatiguerdquo overallcopyvaccine coverage maintained last seasonrsquos increasescopyndash Significant increases in Hispanic and non-Hispanic black children
bull Multiple venues were accessed for vaccination
bull Challenges for the coming season
ndash Maintain the gains
ndash Improve vaccination coverage among adults with risk conditions
and older adults
ndash Improve full vaccination of children recommended for two doses
18
Source Biologics data
166-173m projected for 2011-12 (592011)
0
20
40
60
80
100
120
140
160
180 Ju
ly w
k 1
wk
2
wk
3
wk
4
Au
gu
st w
k 1
wk
2
wk
3
wk
4
Sep
tem
ber
wk
1
wk
2
wk
3
wk
4
Oct
ob
er w
k 1
wk
2
wk
3
wk
4
No
vem
ber
wk
1
wk
2
wk
3
wk
4
Dec
emb
er w
k 1
wk
2
wk
3
wk
4
Jan
ua
ry w
k 1
wk
2
wk
3
wk
4
Feb
rua
ry w
k 1
wk
2
wk
3
wk
4 C
um
ula
tiv
e n
um
be
r o
f d
ose
s d
istr
ibu
ted
in
mil
lio
ns
Month
Cumulative doses of influenza vaccines distributed by month 2004-05 -- 2011-12 seasons US
2011-12
2010-11
2009-10
2008-09
2007-08
2006-07
2005-06
2004-05
asymp1155m by 10072011
19
2011-12 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2011 and March or April 2012
bull National Flu Survey (NFS) November 2011 and March 2012
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
20
Preliminary Influenza Vaccination Coverage in Children 6mo-17yrs 2011-12 Season
Estimated coverage by October 15 2011 22-32
Higher than 17-20 by this date last season
Intended vaccination for children
44 to 56 already have or ldquodefinitely willrdquo be vaccinated
bull Consistent with 2010-11 coverage by end of May 2011 (51)
bull Adult estimates not yet available from the Behavioral Risk Factor Surveillance System (BRFSS)
bull Child estimates from the National Immunization Survey with vaccinations reported by parentsguardians without
provider confirmation Estimated coverage based on interviews conducted 912011-1082011 Projected coverage
including ldquodefinite intentrdquo based on interviews conducted 1012011-1082011 (n=2135)
21
Upcoming Data Releases
bull National Influenza Vaccination Week
(NIVW ) December 4-10 2011
ndash CDC media briefing Dec 5
bull Results from November 2011
ndash National Flu Survey
ndash Panel surveys
raquo Pregnant women
raquo Health Care Personnel
bull Monthly estimates for children and adults from NIS and BRFSS (schedule to be determined)
22
FluVaxView CDC Source for Influenza Vaccination Coverage Data
httpwwwcdcgovfluprofessionalsvaccinationvaccinecoveragehtm 23
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
2010-11 Influenza Season Challenges
bull First ldquopost-pandemicrdquo season
ndash High seasonal vaccine coverage in 2009-10 driven by pandemic
ndash Public interest in vaccination
bull First season with universal flu vaccination recommendations (added group was 18-49 healthy non household contactsmdash15 of US population)
bull New andor expanded venues for vaccinationmdash(schools and pharmacies)
bull Unprecedented vaccine supply
2
Cu
mu
lati
ve
nu
mb
er
of
do
ses
dis
trib
ute
d
in m
illi
on
s
1582m
0
20
40
60
80
100
120
140
160
180
Cumulative doses of influenza vaccines distributed by month 2004-05 -- 2010-11 seasons US
2010-11
2009-10
2008-09
2007-08
2006-07
2005-06
2004-05
July
wk
1
wk
2
wk
3
wk
4
Au
gu
st w
k 1
wk
2
wk
3
wk
4
Sep
tem
ber
wk
1
wk
2
wk
3
wk
4
Oct
ob
er w
k 1
wk
2
wk
3
wk
4
No
vem
ber
wk
1
wk
2
wk
3
wk
4
Dec
emb
er w
k 1
wk
2
wk
3
wk
4
Jan
ua
ry w
k 1
wk
2
wk
3
wk
4
Feb
rua
ry w
k 1
wk
2
wk
3
wk
4
Month
Source Biologics data 3
2010-11 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2010 and April 2011
bull National Flu Survey (NFS) November 2010 and March 2011
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
4
2010-11 Season Vaccination Data Methods bull Final estimates from NIS interviews Sept 2010-June 2011
(6mo-17yrs n=116799) and BRFSS (ge18yrs n=377569)copyndash Online report at httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
ndash Updates interim estimates from MMWR June 10 2011 Vol 60 No
22 Pg 737 - 743
ndash Trends in adults for BRFSS 2007-08 through 2010-11 seasons
bull April 2011 internet panel surveys
ndash Healthcare personnel (n=1931)
bull MMWR August 19 2011 Vol 60 No 32 Pg 1073 - 1077
ndash Pregnant women (n=1457)
bull MMWR August 19 2011 Vol 60 No 32 Pg 1078 - 1082
bull Place of flu vaccination data from BRFSS
ndash January-March 2011 data from 46 states and District of Columbia
ndash MMWR June 17 2011 Vol 60 No 23 Pg 781-785 5
Influenza Vaccination Coverage by Month 2009-10 and 2010-11 Seasons
Online at httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
00
100
200
300
400
500
600 A
UG
SE
P
OC
T
NO
V
DE
C
JAN
FE
B
MA
R
AP
R
MA
Y
Co
ve
rag
e (
)
Month
2010-11
2009-10 seasonal
2009-10 seasonal andor H1N1
00
100
200
300
400
500
600
AU
GS
EP
OC
TN
OV
DE
CJA
NF
EB
MA
RA
PR
MA
Y
Co
ve
rag
e (
)
Month
2010-11
2009-10 seasonal
2009-10 seasonal andor H1N1
Children 6 mo ndash 17 yrs Adults ge18 yrs
6
Influenza Vaccination (trivalent) Coverage by Age 2008-09 through 2010-11 Seasons
Group 2008-09
() 1
2009-10
() 2
2010-11
() 3
Overall (persons aged gt 6 mo) Not Available 412 430
Children 6 mos-17 years 291 437 510
Persons gt 18 yrs 402 404 405
Persons 18-49 yrs all 282 299 305
Persons 18-49 yrs high risk 387 382 390
Persons 50-64 yrs 459 450 445
Persons ge 65 yrs 736 696 666
1 BRFSS 2008-09 for adults child estimate from 2009 NHIS ages 6 mo ndash 18 years online at
httpwwwcdcgovvaccinesstats-survnhis2009-nhishtm
2 BRFSS and National 2009 H1N1 Flu Survey (NHFS) estimates 2009-10 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_0910estimateshtm
3 BRFSS and NIS estimates 2010-11 Online at httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
7
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
80
Most children 6-11 months on 1112010 need 2 doses to be fully vaccinated
From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians without
provider confirmation prior season vaccinations not ascertained
69 63
52
62 62 60 57 55 53
33
22
13 12 12 13 8 10 10
6-11 mo
V
acc
ina
ted
70
60
50
40
30
20
10
0
ge 1 dosescopyge2 dosescopy
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
Age on November 1 2010
8
Influenza Vaccination (trivalent) Coverage by RaceEthnicity 2008-09 through 2010-11 Seasons
Group 2008-09
() 1
2009-10
() 2
2010-11
() 3
Adults by Raceethnicity
White non-Hispanic 435 441 432
Black non-Hispanic 350 328 342
Hispanic 284 293 323
Children by Raceethnicity
White non-Hispanic Not Available 432 485
Black non-Hispanic Not Available 370 508
Hispanic Not Available 469 551
Statistically significant difference compared to non-Hispanic whites (plt005)
1 BRFSS 2008-09 for adults
2 BRFSS and National 2009 H1N1 Flu Survey estimates 2009-10 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_0910estimateshtm
3 BRFSS and NIS estimates 2010-11 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
9
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
10
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
11
Estimated Influenza Vaccination (trivalent) Coverage Healthcare Personnel
V
acc
ina
ted
90
80
70
60
50
42 44 45
53 53
56
62 64
HP 2020 target is 90 percent
40
30
20
10
0
NHIS
BRFSS
NHFS
Internet Panel
2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season
Estimates from the National Health Interview Survey (NHIS) Behavioral Risk Factor Surveillance System (BRFSS) National 2009
H1N1 Flu Survey (NHFS) and internet panel surveys (MMWR August 19 2011 60(32)1073-1077)
12
Estimated Influenza Vaccination (trivalent) Coverage Pregnant Women
80
70
60
50
40
30 27
19
21
21
25
26
36
51 51
27 32
27
51
32
49
HP 2020 target is 80 percent
V
acc
ina
ted
BRFSS Pregnant BRFSS Not Pregnant PRAMS (10 states) NHFS Internet Panel 20
10
0 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season Behavioral Risk Factor Surveillance (BRFSS) data from December interviews only for women 18-44 years pregnant or not pregnant when
interviewed Differences in influenza vaccination coverage between pregnant and not pregnant women were statistically significant
(plt005) only for the 2009-10 and 2010-11 seasons Other estimates for pregnant women from PRAMS (MMWR December 3 2010
59(47)1541-1545) NHFS (Ding et al Am J Obstetrics amp Gynecology June 2011 Supplement) and an internet panel survey (MMWR August
19 2011 60(32)1078-1082)
13
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 201160(23)781-785
Doctors officeHMO
HospitalED
Other clinichealth center
Health Department
Store
Workplace
Senior reccomm center
School
Other non-medical
0 10 20 30 40 50 60
18+ yrs
18-49
50-64
65+
40 18+ yrs
18 18+ yrs
17 18+ yrs
26 65+
52 65+
26 18-49
of vaccinated by place eg supermarket or drug store
BRFSS January-March 2011 data from 46 states and District of Columbia 14
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 2011
Doctorrsquos office is most important medical setting
Workplace and store important non-medical settings
Increase in store vaccination (184) compared to
1998-99 (5) and 2006-07 (7)
Increases in persons vaccinated since 2006-07
Doctorrsquos office 28 million (2006-07) to 37 million (2010-11)
Store 6 million (2006-07) to 17 million (2010-11)
vaccinated in non-medical settings higher for
whites (44) vs blacks (29) Hispanics (34)
Attended college (47) vs lt high school education (28)
15
Summary 44 million more seasonal (trivalent) influenza vaccine
doses distributed than in 2009-10 Coverage levels by census population estimates can provide estimates of doses
administered in the civilian non-institutionalized population
Moderate increase in childrenrsquos coverage since 2009
large increases since 2008
Similar coverage for adults as for 2009-10 trivalent
Coverage among adults ge65 years declining past two seasons
Racialethnic disparities among all adults persist
Non-Hispanic white adults significantly higher levels
Children nH-whites did not have higher coverage vs
other racialethnic groups in 2010-11
Wide variations among states
Maintained last seasonrsquos increases for pregnant women
and healthcare personnel 16
Limitations Self-reported vaccination not validated by medical records
Survey estimates may not be representative
BRFSS does not reach households with only cell phones (will do so next year)
Telephone survey response rates low
Representativeness of internet panel survey estimates needs further evaluation
Tracking trends by season complicated by multiple data sources
with different timeliness and possibly validity
Comparisons to 2009-10 season estimates complicated by unique
circumstances of pandemic and persons could have received
either 2009 H1N1 vaccine only seasonal vaccine only or both
17
Vaccination in the 2010-11 Influenza Season What did the US achieve
bull Despite the expected challenge of ldquoflu fatiguerdquo overallcopyvaccine coverage maintained last seasonrsquos increasescopyndash Significant increases in Hispanic and non-Hispanic black children
bull Multiple venues were accessed for vaccination
bull Challenges for the coming season
ndash Maintain the gains
ndash Improve vaccination coverage among adults with risk conditions
and older adults
ndash Improve full vaccination of children recommended for two doses
18
Source Biologics data
166-173m projected for 2011-12 (592011)
0
20
40
60
80
100
120
140
160
180 Ju
ly w
k 1
wk
2
wk
3
wk
4
Au
gu
st w
k 1
wk
2
wk
3
wk
4
Sep
tem
ber
wk
1
wk
2
wk
3
wk
4
Oct
ob
er w
k 1
wk
2
wk
3
wk
4
No
vem
ber
wk
1
wk
2
wk
3
wk
4
Dec
emb
er w
k 1
wk
2
wk
3
wk
4
Jan
ua
ry w
k 1
wk
2
wk
3
wk
4
Feb
rua
ry w
k 1
wk
2
wk
3
wk
4 C
um
ula
tiv
e n
um
be
r o
f d
ose
s d
istr
ibu
ted
in
mil
lio
ns
Month
Cumulative doses of influenza vaccines distributed by month 2004-05 -- 2011-12 seasons US
2011-12
2010-11
2009-10
2008-09
2007-08
2006-07
2005-06
2004-05
asymp1155m by 10072011
19
2011-12 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2011 and March or April 2012
bull National Flu Survey (NFS) November 2011 and March 2012
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
20
Preliminary Influenza Vaccination Coverage in Children 6mo-17yrs 2011-12 Season
Estimated coverage by October 15 2011 22-32
Higher than 17-20 by this date last season
Intended vaccination for children
44 to 56 already have or ldquodefinitely willrdquo be vaccinated
bull Consistent with 2010-11 coverage by end of May 2011 (51)
bull Adult estimates not yet available from the Behavioral Risk Factor Surveillance System (BRFSS)
bull Child estimates from the National Immunization Survey with vaccinations reported by parentsguardians without
provider confirmation Estimated coverage based on interviews conducted 912011-1082011 Projected coverage
including ldquodefinite intentrdquo based on interviews conducted 1012011-1082011 (n=2135)
21
Upcoming Data Releases
bull National Influenza Vaccination Week
(NIVW ) December 4-10 2011
ndash CDC media briefing Dec 5
bull Results from November 2011
ndash National Flu Survey
ndash Panel surveys
raquo Pregnant women
raquo Health Care Personnel
bull Monthly estimates for children and adults from NIS and BRFSS (schedule to be determined)
22
FluVaxView CDC Source for Influenza Vaccination Coverage Data
httpwwwcdcgovfluprofessionalsvaccinationvaccinecoveragehtm 23
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Cu
mu
lati
ve
nu
mb
er
of
do
ses
dis
trib
ute
d
in m
illi
on
s
1582m
0
20
40
60
80
100
120
140
160
180
Cumulative doses of influenza vaccines distributed by month 2004-05 -- 2010-11 seasons US
2010-11
2009-10
2008-09
2007-08
2006-07
2005-06
2004-05
July
wk
1
wk
2
wk
3
wk
4
Au
gu
st w
k 1
wk
2
wk
3
wk
4
Sep
tem
ber
wk
1
wk
2
wk
3
wk
4
Oct
ob
er w
k 1
wk
2
wk
3
wk
4
No
vem
ber
wk
1
wk
2
wk
3
wk
4
Dec
emb
er w
k 1
wk
2
wk
3
wk
4
Jan
ua
ry w
k 1
wk
2
wk
3
wk
4
Feb
rua
ry w
k 1
wk
2
wk
3
wk
4
Month
Source Biologics data 3
2010-11 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2010 and April 2011
bull National Flu Survey (NFS) November 2010 and March 2011
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
4
2010-11 Season Vaccination Data Methods bull Final estimates from NIS interviews Sept 2010-June 2011
(6mo-17yrs n=116799) and BRFSS (ge18yrs n=377569)copyndash Online report at httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
ndash Updates interim estimates from MMWR June 10 2011 Vol 60 No
22 Pg 737 - 743
ndash Trends in adults for BRFSS 2007-08 through 2010-11 seasons
bull April 2011 internet panel surveys
ndash Healthcare personnel (n=1931)
bull MMWR August 19 2011 Vol 60 No 32 Pg 1073 - 1077
ndash Pregnant women (n=1457)
bull MMWR August 19 2011 Vol 60 No 32 Pg 1078 - 1082
bull Place of flu vaccination data from BRFSS
ndash January-March 2011 data from 46 states and District of Columbia
ndash MMWR June 17 2011 Vol 60 No 23 Pg 781-785 5
Influenza Vaccination Coverage by Month 2009-10 and 2010-11 Seasons
Online at httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
00
100
200
300
400
500
600 A
UG
SE
P
OC
T
NO
V
DE
C
JAN
FE
B
MA
R
AP
R
MA
Y
Co
ve
rag
e (
)
Month
2010-11
2009-10 seasonal
2009-10 seasonal andor H1N1
00
100
200
300
400
500
600
AU
GS
EP
OC
TN
OV
DE
CJA
NF
EB
MA
RA
PR
MA
Y
Co
ve
rag
e (
)
Month
2010-11
2009-10 seasonal
2009-10 seasonal andor H1N1
Children 6 mo ndash 17 yrs Adults ge18 yrs
6
Influenza Vaccination (trivalent) Coverage by Age 2008-09 through 2010-11 Seasons
Group 2008-09
() 1
2009-10
() 2
2010-11
() 3
Overall (persons aged gt 6 mo) Not Available 412 430
Children 6 mos-17 years 291 437 510
Persons gt 18 yrs 402 404 405
Persons 18-49 yrs all 282 299 305
Persons 18-49 yrs high risk 387 382 390
Persons 50-64 yrs 459 450 445
Persons ge 65 yrs 736 696 666
1 BRFSS 2008-09 for adults child estimate from 2009 NHIS ages 6 mo ndash 18 years online at
httpwwwcdcgovvaccinesstats-survnhis2009-nhishtm
2 BRFSS and National 2009 H1N1 Flu Survey (NHFS) estimates 2009-10 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_0910estimateshtm
3 BRFSS and NIS estimates 2010-11 Online at httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
7
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
80
Most children 6-11 months on 1112010 need 2 doses to be fully vaccinated
From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians without
provider confirmation prior season vaccinations not ascertained
69 63
52
62 62 60 57 55 53
33
22
13 12 12 13 8 10 10
6-11 mo
V
acc
ina
ted
70
60
50
40
30
20
10
0
ge 1 dosescopyge2 dosescopy
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
Age on November 1 2010
8
Influenza Vaccination (trivalent) Coverage by RaceEthnicity 2008-09 through 2010-11 Seasons
Group 2008-09
() 1
2009-10
() 2
2010-11
() 3
Adults by Raceethnicity
White non-Hispanic 435 441 432
Black non-Hispanic 350 328 342
Hispanic 284 293 323
Children by Raceethnicity
White non-Hispanic Not Available 432 485
Black non-Hispanic Not Available 370 508
Hispanic Not Available 469 551
Statistically significant difference compared to non-Hispanic whites (plt005)
1 BRFSS 2008-09 for adults
2 BRFSS and National 2009 H1N1 Flu Survey estimates 2009-10 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_0910estimateshtm
3 BRFSS and NIS estimates 2010-11 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
9
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
10
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
11
Estimated Influenza Vaccination (trivalent) Coverage Healthcare Personnel
V
acc
ina
ted
90
80
70
60
50
42 44 45
53 53
56
62 64
HP 2020 target is 90 percent
40
30
20
10
0
NHIS
BRFSS
NHFS
Internet Panel
2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season
Estimates from the National Health Interview Survey (NHIS) Behavioral Risk Factor Surveillance System (BRFSS) National 2009
H1N1 Flu Survey (NHFS) and internet panel surveys (MMWR August 19 2011 60(32)1073-1077)
12
Estimated Influenza Vaccination (trivalent) Coverage Pregnant Women
80
70
60
50
40
30 27
19
21
21
25
26
36
51 51
27 32
27
51
32
49
HP 2020 target is 80 percent
V
acc
ina
ted
BRFSS Pregnant BRFSS Not Pregnant PRAMS (10 states) NHFS Internet Panel 20
10
0 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season Behavioral Risk Factor Surveillance (BRFSS) data from December interviews only for women 18-44 years pregnant or not pregnant when
interviewed Differences in influenza vaccination coverage between pregnant and not pregnant women were statistically significant
(plt005) only for the 2009-10 and 2010-11 seasons Other estimates for pregnant women from PRAMS (MMWR December 3 2010
59(47)1541-1545) NHFS (Ding et al Am J Obstetrics amp Gynecology June 2011 Supplement) and an internet panel survey (MMWR August
19 2011 60(32)1078-1082)
13
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 201160(23)781-785
Doctors officeHMO
HospitalED
Other clinichealth center
Health Department
Store
Workplace
Senior reccomm center
School
Other non-medical
0 10 20 30 40 50 60
18+ yrs
18-49
50-64
65+
40 18+ yrs
18 18+ yrs
17 18+ yrs
26 65+
52 65+
26 18-49
of vaccinated by place eg supermarket or drug store
BRFSS January-March 2011 data from 46 states and District of Columbia 14
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 2011
Doctorrsquos office is most important medical setting
Workplace and store important non-medical settings
Increase in store vaccination (184) compared to
1998-99 (5) and 2006-07 (7)
Increases in persons vaccinated since 2006-07
Doctorrsquos office 28 million (2006-07) to 37 million (2010-11)
Store 6 million (2006-07) to 17 million (2010-11)
vaccinated in non-medical settings higher for
whites (44) vs blacks (29) Hispanics (34)
Attended college (47) vs lt high school education (28)
15
Summary 44 million more seasonal (trivalent) influenza vaccine
doses distributed than in 2009-10 Coverage levels by census population estimates can provide estimates of doses
administered in the civilian non-institutionalized population
Moderate increase in childrenrsquos coverage since 2009
large increases since 2008
Similar coverage for adults as for 2009-10 trivalent
Coverage among adults ge65 years declining past two seasons
Racialethnic disparities among all adults persist
Non-Hispanic white adults significantly higher levels
Children nH-whites did not have higher coverage vs
other racialethnic groups in 2010-11
Wide variations among states
Maintained last seasonrsquos increases for pregnant women
and healthcare personnel 16
Limitations Self-reported vaccination not validated by medical records
Survey estimates may not be representative
BRFSS does not reach households with only cell phones (will do so next year)
Telephone survey response rates low
Representativeness of internet panel survey estimates needs further evaluation
Tracking trends by season complicated by multiple data sources
with different timeliness and possibly validity
Comparisons to 2009-10 season estimates complicated by unique
circumstances of pandemic and persons could have received
either 2009 H1N1 vaccine only seasonal vaccine only or both
17
Vaccination in the 2010-11 Influenza Season What did the US achieve
bull Despite the expected challenge of ldquoflu fatiguerdquo overallcopyvaccine coverage maintained last seasonrsquos increasescopyndash Significant increases in Hispanic and non-Hispanic black children
bull Multiple venues were accessed for vaccination
bull Challenges for the coming season
ndash Maintain the gains
ndash Improve vaccination coverage among adults with risk conditions
and older adults
ndash Improve full vaccination of children recommended for two doses
18
Source Biologics data
166-173m projected for 2011-12 (592011)
0
20
40
60
80
100
120
140
160
180 Ju
ly w
k 1
wk
2
wk
3
wk
4
Au
gu
st w
k 1
wk
2
wk
3
wk
4
Sep
tem
ber
wk
1
wk
2
wk
3
wk
4
Oct
ob
er w
k 1
wk
2
wk
3
wk
4
No
vem
ber
wk
1
wk
2
wk
3
wk
4
Dec
emb
er w
k 1
wk
2
wk
3
wk
4
Jan
ua
ry w
k 1
wk
2
wk
3
wk
4
Feb
rua
ry w
k 1
wk
2
wk
3
wk
4 C
um
ula
tiv
e n
um
be
r o
f d
ose
s d
istr
ibu
ted
in
mil
lio
ns
Month
Cumulative doses of influenza vaccines distributed by month 2004-05 -- 2011-12 seasons US
2011-12
2010-11
2009-10
2008-09
2007-08
2006-07
2005-06
2004-05
asymp1155m by 10072011
19
2011-12 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2011 and March or April 2012
bull National Flu Survey (NFS) November 2011 and March 2012
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
20
Preliminary Influenza Vaccination Coverage in Children 6mo-17yrs 2011-12 Season
Estimated coverage by October 15 2011 22-32
Higher than 17-20 by this date last season
Intended vaccination for children
44 to 56 already have or ldquodefinitely willrdquo be vaccinated
bull Consistent with 2010-11 coverage by end of May 2011 (51)
bull Adult estimates not yet available from the Behavioral Risk Factor Surveillance System (BRFSS)
bull Child estimates from the National Immunization Survey with vaccinations reported by parentsguardians without
provider confirmation Estimated coverage based on interviews conducted 912011-1082011 Projected coverage
including ldquodefinite intentrdquo based on interviews conducted 1012011-1082011 (n=2135)
21
Upcoming Data Releases
bull National Influenza Vaccination Week
(NIVW ) December 4-10 2011
ndash CDC media briefing Dec 5
bull Results from November 2011
ndash National Flu Survey
ndash Panel surveys
raquo Pregnant women
raquo Health Care Personnel
bull Monthly estimates for children and adults from NIS and BRFSS (schedule to be determined)
22
FluVaxView CDC Source for Influenza Vaccination Coverage Data
httpwwwcdcgovfluprofessionalsvaccinationvaccinecoveragehtm 23
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
2010-11 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2010 and April 2011
bull National Flu Survey (NFS) November 2010 and March 2011
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
4
2010-11 Season Vaccination Data Methods bull Final estimates from NIS interviews Sept 2010-June 2011
(6mo-17yrs n=116799) and BRFSS (ge18yrs n=377569)copyndash Online report at httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
ndash Updates interim estimates from MMWR June 10 2011 Vol 60 No
22 Pg 737 - 743
ndash Trends in adults for BRFSS 2007-08 through 2010-11 seasons
bull April 2011 internet panel surveys
ndash Healthcare personnel (n=1931)
bull MMWR August 19 2011 Vol 60 No 32 Pg 1073 - 1077
ndash Pregnant women (n=1457)
bull MMWR August 19 2011 Vol 60 No 32 Pg 1078 - 1082
bull Place of flu vaccination data from BRFSS
ndash January-March 2011 data from 46 states and District of Columbia
ndash MMWR June 17 2011 Vol 60 No 23 Pg 781-785 5
Influenza Vaccination Coverage by Month 2009-10 and 2010-11 Seasons
Online at httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
00
100
200
300
400
500
600 A
UG
SE
P
OC
T
NO
V
DE
C
JAN
FE
B
MA
R
AP
R
MA
Y
Co
ve
rag
e (
)
Month
2010-11
2009-10 seasonal
2009-10 seasonal andor H1N1
00
100
200
300
400
500
600
AU
GS
EP
OC
TN
OV
DE
CJA
NF
EB
MA
RA
PR
MA
Y
Co
ve
rag
e (
)
Month
2010-11
2009-10 seasonal
2009-10 seasonal andor H1N1
Children 6 mo ndash 17 yrs Adults ge18 yrs
6
Influenza Vaccination (trivalent) Coverage by Age 2008-09 through 2010-11 Seasons
Group 2008-09
() 1
2009-10
() 2
2010-11
() 3
Overall (persons aged gt 6 mo) Not Available 412 430
Children 6 mos-17 years 291 437 510
Persons gt 18 yrs 402 404 405
Persons 18-49 yrs all 282 299 305
Persons 18-49 yrs high risk 387 382 390
Persons 50-64 yrs 459 450 445
Persons ge 65 yrs 736 696 666
1 BRFSS 2008-09 for adults child estimate from 2009 NHIS ages 6 mo ndash 18 years online at
httpwwwcdcgovvaccinesstats-survnhis2009-nhishtm
2 BRFSS and National 2009 H1N1 Flu Survey (NHFS) estimates 2009-10 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_0910estimateshtm
3 BRFSS and NIS estimates 2010-11 Online at httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
7
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
80
Most children 6-11 months on 1112010 need 2 doses to be fully vaccinated
From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians without
provider confirmation prior season vaccinations not ascertained
69 63
52
62 62 60 57 55 53
33
22
13 12 12 13 8 10 10
6-11 mo
V
acc
ina
ted
70
60
50
40
30
20
10
0
ge 1 dosescopyge2 dosescopy
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
Age on November 1 2010
8
Influenza Vaccination (trivalent) Coverage by RaceEthnicity 2008-09 through 2010-11 Seasons
Group 2008-09
() 1
2009-10
() 2
2010-11
() 3
Adults by Raceethnicity
White non-Hispanic 435 441 432
Black non-Hispanic 350 328 342
Hispanic 284 293 323
Children by Raceethnicity
White non-Hispanic Not Available 432 485
Black non-Hispanic Not Available 370 508
Hispanic Not Available 469 551
Statistically significant difference compared to non-Hispanic whites (plt005)
1 BRFSS 2008-09 for adults
2 BRFSS and National 2009 H1N1 Flu Survey estimates 2009-10 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_0910estimateshtm
3 BRFSS and NIS estimates 2010-11 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
9
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
10
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
11
Estimated Influenza Vaccination (trivalent) Coverage Healthcare Personnel
V
acc
ina
ted
90
80
70
60
50
42 44 45
53 53
56
62 64
HP 2020 target is 90 percent
40
30
20
10
0
NHIS
BRFSS
NHFS
Internet Panel
2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season
Estimates from the National Health Interview Survey (NHIS) Behavioral Risk Factor Surveillance System (BRFSS) National 2009
H1N1 Flu Survey (NHFS) and internet panel surveys (MMWR August 19 2011 60(32)1073-1077)
12
Estimated Influenza Vaccination (trivalent) Coverage Pregnant Women
80
70
60
50
40
30 27
19
21
21
25
26
36
51 51
27 32
27
51
32
49
HP 2020 target is 80 percent
V
acc
ina
ted
BRFSS Pregnant BRFSS Not Pregnant PRAMS (10 states) NHFS Internet Panel 20
10
0 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season Behavioral Risk Factor Surveillance (BRFSS) data from December interviews only for women 18-44 years pregnant or not pregnant when
interviewed Differences in influenza vaccination coverage between pregnant and not pregnant women were statistically significant
(plt005) only for the 2009-10 and 2010-11 seasons Other estimates for pregnant women from PRAMS (MMWR December 3 2010
59(47)1541-1545) NHFS (Ding et al Am J Obstetrics amp Gynecology June 2011 Supplement) and an internet panel survey (MMWR August
19 2011 60(32)1078-1082)
13
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 201160(23)781-785
Doctors officeHMO
HospitalED
Other clinichealth center
Health Department
Store
Workplace
Senior reccomm center
School
Other non-medical
0 10 20 30 40 50 60
18+ yrs
18-49
50-64
65+
40 18+ yrs
18 18+ yrs
17 18+ yrs
26 65+
52 65+
26 18-49
of vaccinated by place eg supermarket or drug store
BRFSS January-March 2011 data from 46 states and District of Columbia 14
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 2011
Doctorrsquos office is most important medical setting
Workplace and store important non-medical settings
Increase in store vaccination (184) compared to
1998-99 (5) and 2006-07 (7)
Increases in persons vaccinated since 2006-07
Doctorrsquos office 28 million (2006-07) to 37 million (2010-11)
Store 6 million (2006-07) to 17 million (2010-11)
vaccinated in non-medical settings higher for
whites (44) vs blacks (29) Hispanics (34)
Attended college (47) vs lt high school education (28)
15
Summary 44 million more seasonal (trivalent) influenza vaccine
doses distributed than in 2009-10 Coverage levels by census population estimates can provide estimates of doses
administered in the civilian non-institutionalized population
Moderate increase in childrenrsquos coverage since 2009
large increases since 2008
Similar coverage for adults as for 2009-10 trivalent
Coverage among adults ge65 years declining past two seasons
Racialethnic disparities among all adults persist
Non-Hispanic white adults significantly higher levels
Children nH-whites did not have higher coverage vs
other racialethnic groups in 2010-11
Wide variations among states
Maintained last seasonrsquos increases for pregnant women
and healthcare personnel 16
Limitations Self-reported vaccination not validated by medical records
Survey estimates may not be representative
BRFSS does not reach households with only cell phones (will do so next year)
Telephone survey response rates low
Representativeness of internet panel survey estimates needs further evaluation
Tracking trends by season complicated by multiple data sources
with different timeliness and possibly validity
Comparisons to 2009-10 season estimates complicated by unique
circumstances of pandemic and persons could have received
either 2009 H1N1 vaccine only seasonal vaccine only or both
17
Vaccination in the 2010-11 Influenza Season What did the US achieve
bull Despite the expected challenge of ldquoflu fatiguerdquo overallcopyvaccine coverage maintained last seasonrsquos increasescopyndash Significant increases in Hispanic and non-Hispanic black children
bull Multiple venues were accessed for vaccination
bull Challenges for the coming season
ndash Maintain the gains
ndash Improve vaccination coverage among adults with risk conditions
and older adults
ndash Improve full vaccination of children recommended for two doses
18
Source Biologics data
166-173m projected for 2011-12 (592011)
0
20
40
60
80
100
120
140
160
180 Ju
ly w
k 1
wk
2
wk
3
wk
4
Au
gu
st w
k 1
wk
2
wk
3
wk
4
Sep
tem
ber
wk
1
wk
2
wk
3
wk
4
Oct
ob
er w
k 1
wk
2
wk
3
wk
4
No
vem
ber
wk
1
wk
2
wk
3
wk
4
Dec
emb
er w
k 1
wk
2
wk
3
wk
4
Jan
ua
ry w
k 1
wk
2
wk
3
wk
4
Feb
rua
ry w
k 1
wk
2
wk
3
wk
4 C
um
ula
tiv
e n
um
be
r o
f d
ose
s d
istr
ibu
ted
in
mil
lio
ns
Month
Cumulative doses of influenza vaccines distributed by month 2004-05 -- 2011-12 seasons US
2011-12
2010-11
2009-10
2008-09
2007-08
2006-07
2005-06
2004-05
asymp1155m by 10072011
19
2011-12 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2011 and March or April 2012
bull National Flu Survey (NFS) November 2011 and March 2012
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
20
Preliminary Influenza Vaccination Coverage in Children 6mo-17yrs 2011-12 Season
Estimated coverage by October 15 2011 22-32
Higher than 17-20 by this date last season
Intended vaccination for children
44 to 56 already have or ldquodefinitely willrdquo be vaccinated
bull Consistent with 2010-11 coverage by end of May 2011 (51)
bull Adult estimates not yet available from the Behavioral Risk Factor Surveillance System (BRFSS)
bull Child estimates from the National Immunization Survey with vaccinations reported by parentsguardians without
provider confirmation Estimated coverage based on interviews conducted 912011-1082011 Projected coverage
including ldquodefinite intentrdquo based on interviews conducted 1012011-1082011 (n=2135)
21
Upcoming Data Releases
bull National Influenza Vaccination Week
(NIVW ) December 4-10 2011
ndash CDC media briefing Dec 5
bull Results from November 2011
ndash National Flu Survey
ndash Panel surveys
raquo Pregnant women
raquo Health Care Personnel
bull Monthly estimates for children and adults from NIS and BRFSS (schedule to be determined)
22
FluVaxView CDC Source for Influenza Vaccination Coverage Data
httpwwwcdcgovfluprofessionalsvaccinationvaccinecoveragehtm 23
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
2010-11 Season Vaccination Data Methods bull Final estimates from NIS interviews Sept 2010-June 2011
(6mo-17yrs n=116799) and BRFSS (ge18yrs n=377569)copyndash Online report at httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
ndash Updates interim estimates from MMWR June 10 2011 Vol 60 No
22 Pg 737 - 743
ndash Trends in adults for BRFSS 2007-08 through 2010-11 seasons
bull April 2011 internet panel surveys
ndash Healthcare personnel (n=1931)
bull MMWR August 19 2011 Vol 60 No 32 Pg 1073 - 1077
ndash Pregnant women (n=1457)
bull MMWR August 19 2011 Vol 60 No 32 Pg 1078 - 1082
bull Place of flu vaccination data from BRFSS
ndash January-March 2011 data from 46 states and District of Columbia
ndash MMWR June 17 2011 Vol 60 No 23 Pg 781-785 5
Influenza Vaccination Coverage by Month 2009-10 and 2010-11 Seasons
Online at httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
00
100
200
300
400
500
600 A
UG
SE
P
OC
T
NO
V
DE
C
JAN
FE
B
MA
R
AP
R
MA
Y
Co
ve
rag
e (
)
Month
2010-11
2009-10 seasonal
2009-10 seasonal andor H1N1
00
100
200
300
400
500
600
AU
GS
EP
OC
TN
OV
DE
CJA
NF
EB
MA
RA
PR
MA
Y
Co
ve
rag
e (
)
Month
2010-11
2009-10 seasonal
2009-10 seasonal andor H1N1
Children 6 mo ndash 17 yrs Adults ge18 yrs
6
Influenza Vaccination (trivalent) Coverage by Age 2008-09 through 2010-11 Seasons
Group 2008-09
() 1
2009-10
() 2
2010-11
() 3
Overall (persons aged gt 6 mo) Not Available 412 430
Children 6 mos-17 years 291 437 510
Persons gt 18 yrs 402 404 405
Persons 18-49 yrs all 282 299 305
Persons 18-49 yrs high risk 387 382 390
Persons 50-64 yrs 459 450 445
Persons ge 65 yrs 736 696 666
1 BRFSS 2008-09 for adults child estimate from 2009 NHIS ages 6 mo ndash 18 years online at
httpwwwcdcgovvaccinesstats-survnhis2009-nhishtm
2 BRFSS and National 2009 H1N1 Flu Survey (NHFS) estimates 2009-10 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_0910estimateshtm
3 BRFSS and NIS estimates 2010-11 Online at httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
7
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
80
Most children 6-11 months on 1112010 need 2 doses to be fully vaccinated
From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians without
provider confirmation prior season vaccinations not ascertained
69 63
52
62 62 60 57 55 53
33
22
13 12 12 13 8 10 10
6-11 mo
V
acc
ina
ted
70
60
50
40
30
20
10
0
ge 1 dosescopyge2 dosescopy
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
Age on November 1 2010
8
Influenza Vaccination (trivalent) Coverage by RaceEthnicity 2008-09 through 2010-11 Seasons
Group 2008-09
() 1
2009-10
() 2
2010-11
() 3
Adults by Raceethnicity
White non-Hispanic 435 441 432
Black non-Hispanic 350 328 342
Hispanic 284 293 323
Children by Raceethnicity
White non-Hispanic Not Available 432 485
Black non-Hispanic Not Available 370 508
Hispanic Not Available 469 551
Statistically significant difference compared to non-Hispanic whites (plt005)
1 BRFSS 2008-09 for adults
2 BRFSS and National 2009 H1N1 Flu Survey estimates 2009-10 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_0910estimateshtm
3 BRFSS and NIS estimates 2010-11 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
9
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
10
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
11
Estimated Influenza Vaccination (trivalent) Coverage Healthcare Personnel
V
acc
ina
ted
90
80
70
60
50
42 44 45
53 53
56
62 64
HP 2020 target is 90 percent
40
30
20
10
0
NHIS
BRFSS
NHFS
Internet Panel
2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season
Estimates from the National Health Interview Survey (NHIS) Behavioral Risk Factor Surveillance System (BRFSS) National 2009
H1N1 Flu Survey (NHFS) and internet panel surveys (MMWR August 19 2011 60(32)1073-1077)
12
Estimated Influenza Vaccination (trivalent) Coverage Pregnant Women
80
70
60
50
40
30 27
19
21
21
25
26
36
51 51
27 32
27
51
32
49
HP 2020 target is 80 percent
V
acc
ina
ted
BRFSS Pregnant BRFSS Not Pregnant PRAMS (10 states) NHFS Internet Panel 20
10
0 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season Behavioral Risk Factor Surveillance (BRFSS) data from December interviews only for women 18-44 years pregnant or not pregnant when
interviewed Differences in influenza vaccination coverage between pregnant and not pregnant women were statistically significant
(plt005) only for the 2009-10 and 2010-11 seasons Other estimates for pregnant women from PRAMS (MMWR December 3 2010
59(47)1541-1545) NHFS (Ding et al Am J Obstetrics amp Gynecology June 2011 Supplement) and an internet panel survey (MMWR August
19 2011 60(32)1078-1082)
13
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 201160(23)781-785
Doctors officeHMO
HospitalED
Other clinichealth center
Health Department
Store
Workplace
Senior reccomm center
School
Other non-medical
0 10 20 30 40 50 60
18+ yrs
18-49
50-64
65+
40 18+ yrs
18 18+ yrs
17 18+ yrs
26 65+
52 65+
26 18-49
of vaccinated by place eg supermarket or drug store
BRFSS January-March 2011 data from 46 states and District of Columbia 14
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 2011
Doctorrsquos office is most important medical setting
Workplace and store important non-medical settings
Increase in store vaccination (184) compared to
1998-99 (5) and 2006-07 (7)
Increases in persons vaccinated since 2006-07
Doctorrsquos office 28 million (2006-07) to 37 million (2010-11)
Store 6 million (2006-07) to 17 million (2010-11)
vaccinated in non-medical settings higher for
whites (44) vs blacks (29) Hispanics (34)
Attended college (47) vs lt high school education (28)
15
Summary 44 million more seasonal (trivalent) influenza vaccine
doses distributed than in 2009-10 Coverage levels by census population estimates can provide estimates of doses
administered in the civilian non-institutionalized population
Moderate increase in childrenrsquos coverage since 2009
large increases since 2008
Similar coverage for adults as for 2009-10 trivalent
Coverage among adults ge65 years declining past two seasons
Racialethnic disparities among all adults persist
Non-Hispanic white adults significantly higher levels
Children nH-whites did not have higher coverage vs
other racialethnic groups in 2010-11
Wide variations among states
Maintained last seasonrsquos increases for pregnant women
and healthcare personnel 16
Limitations Self-reported vaccination not validated by medical records
Survey estimates may not be representative
BRFSS does not reach households with only cell phones (will do so next year)
Telephone survey response rates low
Representativeness of internet panel survey estimates needs further evaluation
Tracking trends by season complicated by multiple data sources
with different timeliness and possibly validity
Comparisons to 2009-10 season estimates complicated by unique
circumstances of pandemic and persons could have received
either 2009 H1N1 vaccine only seasonal vaccine only or both
17
Vaccination in the 2010-11 Influenza Season What did the US achieve
bull Despite the expected challenge of ldquoflu fatiguerdquo overallcopyvaccine coverage maintained last seasonrsquos increasescopyndash Significant increases in Hispanic and non-Hispanic black children
bull Multiple venues were accessed for vaccination
bull Challenges for the coming season
ndash Maintain the gains
ndash Improve vaccination coverage among adults with risk conditions
and older adults
ndash Improve full vaccination of children recommended for two doses
18
Source Biologics data
166-173m projected for 2011-12 (592011)
0
20
40
60
80
100
120
140
160
180 Ju
ly w
k 1
wk
2
wk
3
wk
4
Au
gu
st w
k 1
wk
2
wk
3
wk
4
Sep
tem
ber
wk
1
wk
2
wk
3
wk
4
Oct
ob
er w
k 1
wk
2
wk
3
wk
4
No
vem
ber
wk
1
wk
2
wk
3
wk
4
Dec
emb
er w
k 1
wk
2
wk
3
wk
4
Jan
ua
ry w
k 1
wk
2
wk
3
wk
4
Feb
rua
ry w
k 1
wk
2
wk
3
wk
4 C
um
ula
tiv
e n
um
be
r o
f d
ose
s d
istr
ibu
ted
in
mil
lio
ns
Month
Cumulative doses of influenza vaccines distributed by month 2004-05 -- 2011-12 seasons US
2011-12
2010-11
2009-10
2008-09
2007-08
2006-07
2005-06
2004-05
asymp1155m by 10072011
19
2011-12 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2011 and March or April 2012
bull National Flu Survey (NFS) November 2011 and March 2012
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
20
Preliminary Influenza Vaccination Coverage in Children 6mo-17yrs 2011-12 Season
Estimated coverage by October 15 2011 22-32
Higher than 17-20 by this date last season
Intended vaccination for children
44 to 56 already have or ldquodefinitely willrdquo be vaccinated
bull Consistent with 2010-11 coverage by end of May 2011 (51)
bull Adult estimates not yet available from the Behavioral Risk Factor Surveillance System (BRFSS)
bull Child estimates from the National Immunization Survey with vaccinations reported by parentsguardians without
provider confirmation Estimated coverage based on interviews conducted 912011-1082011 Projected coverage
including ldquodefinite intentrdquo based on interviews conducted 1012011-1082011 (n=2135)
21
Upcoming Data Releases
bull National Influenza Vaccination Week
(NIVW ) December 4-10 2011
ndash CDC media briefing Dec 5
bull Results from November 2011
ndash National Flu Survey
ndash Panel surveys
raquo Pregnant women
raquo Health Care Personnel
bull Monthly estimates for children and adults from NIS and BRFSS (schedule to be determined)
22
FluVaxView CDC Source for Influenza Vaccination Coverage Data
httpwwwcdcgovfluprofessionalsvaccinationvaccinecoveragehtm 23
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Influenza Vaccination Coverage by Month 2009-10 and 2010-11 Seasons
Online at httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
00
100
200
300
400
500
600 A
UG
SE
P
OC
T
NO
V
DE
C
JAN
FE
B
MA
R
AP
R
MA
Y
Co
ve
rag
e (
)
Month
2010-11
2009-10 seasonal
2009-10 seasonal andor H1N1
00
100
200
300
400
500
600
AU
GS
EP
OC
TN
OV
DE
CJA
NF
EB
MA
RA
PR
MA
Y
Co
ve
rag
e (
)
Month
2010-11
2009-10 seasonal
2009-10 seasonal andor H1N1
Children 6 mo ndash 17 yrs Adults ge18 yrs
6
Influenza Vaccination (trivalent) Coverage by Age 2008-09 through 2010-11 Seasons
Group 2008-09
() 1
2009-10
() 2
2010-11
() 3
Overall (persons aged gt 6 mo) Not Available 412 430
Children 6 mos-17 years 291 437 510
Persons gt 18 yrs 402 404 405
Persons 18-49 yrs all 282 299 305
Persons 18-49 yrs high risk 387 382 390
Persons 50-64 yrs 459 450 445
Persons ge 65 yrs 736 696 666
1 BRFSS 2008-09 for adults child estimate from 2009 NHIS ages 6 mo ndash 18 years online at
httpwwwcdcgovvaccinesstats-survnhis2009-nhishtm
2 BRFSS and National 2009 H1N1 Flu Survey (NHFS) estimates 2009-10 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_0910estimateshtm
3 BRFSS and NIS estimates 2010-11 Online at httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
7
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
80
Most children 6-11 months on 1112010 need 2 doses to be fully vaccinated
From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians without
provider confirmation prior season vaccinations not ascertained
69 63
52
62 62 60 57 55 53
33
22
13 12 12 13 8 10 10
6-11 mo
V
acc
ina
ted
70
60
50
40
30
20
10
0
ge 1 dosescopyge2 dosescopy
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
Age on November 1 2010
8
Influenza Vaccination (trivalent) Coverage by RaceEthnicity 2008-09 through 2010-11 Seasons
Group 2008-09
() 1
2009-10
() 2
2010-11
() 3
Adults by Raceethnicity
White non-Hispanic 435 441 432
Black non-Hispanic 350 328 342
Hispanic 284 293 323
Children by Raceethnicity
White non-Hispanic Not Available 432 485
Black non-Hispanic Not Available 370 508
Hispanic Not Available 469 551
Statistically significant difference compared to non-Hispanic whites (plt005)
1 BRFSS 2008-09 for adults
2 BRFSS and National 2009 H1N1 Flu Survey estimates 2009-10 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_0910estimateshtm
3 BRFSS and NIS estimates 2010-11 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
9
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
10
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
11
Estimated Influenza Vaccination (trivalent) Coverage Healthcare Personnel
V
acc
ina
ted
90
80
70
60
50
42 44 45
53 53
56
62 64
HP 2020 target is 90 percent
40
30
20
10
0
NHIS
BRFSS
NHFS
Internet Panel
2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season
Estimates from the National Health Interview Survey (NHIS) Behavioral Risk Factor Surveillance System (BRFSS) National 2009
H1N1 Flu Survey (NHFS) and internet panel surveys (MMWR August 19 2011 60(32)1073-1077)
12
Estimated Influenza Vaccination (trivalent) Coverage Pregnant Women
80
70
60
50
40
30 27
19
21
21
25
26
36
51 51
27 32
27
51
32
49
HP 2020 target is 80 percent
V
acc
ina
ted
BRFSS Pregnant BRFSS Not Pregnant PRAMS (10 states) NHFS Internet Panel 20
10
0 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season Behavioral Risk Factor Surveillance (BRFSS) data from December interviews only for women 18-44 years pregnant or not pregnant when
interviewed Differences in influenza vaccination coverage between pregnant and not pregnant women were statistically significant
(plt005) only for the 2009-10 and 2010-11 seasons Other estimates for pregnant women from PRAMS (MMWR December 3 2010
59(47)1541-1545) NHFS (Ding et al Am J Obstetrics amp Gynecology June 2011 Supplement) and an internet panel survey (MMWR August
19 2011 60(32)1078-1082)
13
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 201160(23)781-785
Doctors officeHMO
HospitalED
Other clinichealth center
Health Department
Store
Workplace
Senior reccomm center
School
Other non-medical
0 10 20 30 40 50 60
18+ yrs
18-49
50-64
65+
40 18+ yrs
18 18+ yrs
17 18+ yrs
26 65+
52 65+
26 18-49
of vaccinated by place eg supermarket or drug store
BRFSS January-March 2011 data from 46 states and District of Columbia 14
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 2011
Doctorrsquos office is most important medical setting
Workplace and store important non-medical settings
Increase in store vaccination (184) compared to
1998-99 (5) and 2006-07 (7)
Increases in persons vaccinated since 2006-07
Doctorrsquos office 28 million (2006-07) to 37 million (2010-11)
Store 6 million (2006-07) to 17 million (2010-11)
vaccinated in non-medical settings higher for
whites (44) vs blacks (29) Hispanics (34)
Attended college (47) vs lt high school education (28)
15
Summary 44 million more seasonal (trivalent) influenza vaccine
doses distributed than in 2009-10 Coverage levels by census population estimates can provide estimates of doses
administered in the civilian non-institutionalized population
Moderate increase in childrenrsquos coverage since 2009
large increases since 2008
Similar coverage for adults as for 2009-10 trivalent
Coverage among adults ge65 years declining past two seasons
Racialethnic disparities among all adults persist
Non-Hispanic white adults significantly higher levels
Children nH-whites did not have higher coverage vs
other racialethnic groups in 2010-11
Wide variations among states
Maintained last seasonrsquos increases for pregnant women
and healthcare personnel 16
Limitations Self-reported vaccination not validated by medical records
Survey estimates may not be representative
BRFSS does not reach households with only cell phones (will do so next year)
Telephone survey response rates low
Representativeness of internet panel survey estimates needs further evaluation
Tracking trends by season complicated by multiple data sources
with different timeliness and possibly validity
Comparisons to 2009-10 season estimates complicated by unique
circumstances of pandemic and persons could have received
either 2009 H1N1 vaccine only seasonal vaccine only or both
17
Vaccination in the 2010-11 Influenza Season What did the US achieve
bull Despite the expected challenge of ldquoflu fatiguerdquo overallcopyvaccine coverage maintained last seasonrsquos increasescopyndash Significant increases in Hispanic and non-Hispanic black children
bull Multiple venues were accessed for vaccination
bull Challenges for the coming season
ndash Maintain the gains
ndash Improve vaccination coverage among adults with risk conditions
and older adults
ndash Improve full vaccination of children recommended for two doses
18
Source Biologics data
166-173m projected for 2011-12 (592011)
0
20
40
60
80
100
120
140
160
180 Ju
ly w
k 1
wk
2
wk
3
wk
4
Au
gu
st w
k 1
wk
2
wk
3
wk
4
Sep
tem
ber
wk
1
wk
2
wk
3
wk
4
Oct
ob
er w
k 1
wk
2
wk
3
wk
4
No
vem
ber
wk
1
wk
2
wk
3
wk
4
Dec
emb
er w
k 1
wk
2
wk
3
wk
4
Jan
ua
ry w
k 1
wk
2
wk
3
wk
4
Feb
rua
ry w
k 1
wk
2
wk
3
wk
4 C
um
ula
tiv
e n
um
be
r o
f d
ose
s d
istr
ibu
ted
in
mil
lio
ns
Month
Cumulative doses of influenza vaccines distributed by month 2004-05 -- 2011-12 seasons US
2011-12
2010-11
2009-10
2008-09
2007-08
2006-07
2005-06
2004-05
asymp1155m by 10072011
19
2011-12 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2011 and March or April 2012
bull National Flu Survey (NFS) November 2011 and March 2012
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
20
Preliminary Influenza Vaccination Coverage in Children 6mo-17yrs 2011-12 Season
Estimated coverage by October 15 2011 22-32
Higher than 17-20 by this date last season
Intended vaccination for children
44 to 56 already have or ldquodefinitely willrdquo be vaccinated
bull Consistent with 2010-11 coverage by end of May 2011 (51)
bull Adult estimates not yet available from the Behavioral Risk Factor Surveillance System (BRFSS)
bull Child estimates from the National Immunization Survey with vaccinations reported by parentsguardians without
provider confirmation Estimated coverage based on interviews conducted 912011-1082011 Projected coverage
including ldquodefinite intentrdquo based on interviews conducted 1012011-1082011 (n=2135)
21
Upcoming Data Releases
bull National Influenza Vaccination Week
(NIVW ) December 4-10 2011
ndash CDC media briefing Dec 5
bull Results from November 2011
ndash National Flu Survey
ndash Panel surveys
raquo Pregnant women
raquo Health Care Personnel
bull Monthly estimates for children and adults from NIS and BRFSS (schedule to be determined)
22
FluVaxView CDC Source for Influenza Vaccination Coverage Data
httpwwwcdcgovfluprofessionalsvaccinationvaccinecoveragehtm 23
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Influenza Vaccination (trivalent) Coverage by Age 2008-09 through 2010-11 Seasons
Group 2008-09
() 1
2009-10
() 2
2010-11
() 3
Overall (persons aged gt 6 mo) Not Available 412 430
Children 6 mos-17 years 291 437 510
Persons gt 18 yrs 402 404 405
Persons 18-49 yrs all 282 299 305
Persons 18-49 yrs high risk 387 382 390
Persons 50-64 yrs 459 450 445
Persons ge 65 yrs 736 696 666
1 BRFSS 2008-09 for adults child estimate from 2009 NHIS ages 6 mo ndash 18 years online at
httpwwwcdcgovvaccinesstats-survnhis2009-nhishtm
2 BRFSS and National 2009 H1N1 Flu Survey (NHFS) estimates 2009-10 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_0910estimateshtm
3 BRFSS and NIS estimates 2010-11 Online at httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
7
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
80
Most children 6-11 months on 1112010 need 2 doses to be fully vaccinated
From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians without
provider confirmation prior season vaccinations not ascertained
69 63
52
62 62 60 57 55 53
33
22
13 12 12 13 8 10 10
6-11 mo
V
acc
ina
ted
70
60
50
40
30
20
10
0
ge 1 dosescopyge2 dosescopy
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
Age on November 1 2010
8
Influenza Vaccination (trivalent) Coverage by RaceEthnicity 2008-09 through 2010-11 Seasons
Group 2008-09
() 1
2009-10
() 2
2010-11
() 3
Adults by Raceethnicity
White non-Hispanic 435 441 432
Black non-Hispanic 350 328 342
Hispanic 284 293 323
Children by Raceethnicity
White non-Hispanic Not Available 432 485
Black non-Hispanic Not Available 370 508
Hispanic Not Available 469 551
Statistically significant difference compared to non-Hispanic whites (plt005)
1 BRFSS 2008-09 for adults
2 BRFSS and National 2009 H1N1 Flu Survey estimates 2009-10 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_0910estimateshtm
3 BRFSS and NIS estimates 2010-11 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
9
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
10
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
11
Estimated Influenza Vaccination (trivalent) Coverage Healthcare Personnel
V
acc
ina
ted
90
80
70
60
50
42 44 45
53 53
56
62 64
HP 2020 target is 90 percent
40
30
20
10
0
NHIS
BRFSS
NHFS
Internet Panel
2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season
Estimates from the National Health Interview Survey (NHIS) Behavioral Risk Factor Surveillance System (BRFSS) National 2009
H1N1 Flu Survey (NHFS) and internet panel surveys (MMWR August 19 2011 60(32)1073-1077)
12
Estimated Influenza Vaccination (trivalent) Coverage Pregnant Women
80
70
60
50
40
30 27
19
21
21
25
26
36
51 51
27 32
27
51
32
49
HP 2020 target is 80 percent
V
acc
ina
ted
BRFSS Pregnant BRFSS Not Pregnant PRAMS (10 states) NHFS Internet Panel 20
10
0 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season Behavioral Risk Factor Surveillance (BRFSS) data from December interviews only for women 18-44 years pregnant or not pregnant when
interviewed Differences in influenza vaccination coverage between pregnant and not pregnant women were statistically significant
(plt005) only for the 2009-10 and 2010-11 seasons Other estimates for pregnant women from PRAMS (MMWR December 3 2010
59(47)1541-1545) NHFS (Ding et al Am J Obstetrics amp Gynecology June 2011 Supplement) and an internet panel survey (MMWR August
19 2011 60(32)1078-1082)
13
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 201160(23)781-785
Doctors officeHMO
HospitalED
Other clinichealth center
Health Department
Store
Workplace
Senior reccomm center
School
Other non-medical
0 10 20 30 40 50 60
18+ yrs
18-49
50-64
65+
40 18+ yrs
18 18+ yrs
17 18+ yrs
26 65+
52 65+
26 18-49
of vaccinated by place eg supermarket or drug store
BRFSS January-March 2011 data from 46 states and District of Columbia 14
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 2011
Doctorrsquos office is most important medical setting
Workplace and store important non-medical settings
Increase in store vaccination (184) compared to
1998-99 (5) and 2006-07 (7)
Increases in persons vaccinated since 2006-07
Doctorrsquos office 28 million (2006-07) to 37 million (2010-11)
Store 6 million (2006-07) to 17 million (2010-11)
vaccinated in non-medical settings higher for
whites (44) vs blacks (29) Hispanics (34)
Attended college (47) vs lt high school education (28)
15
Summary 44 million more seasonal (trivalent) influenza vaccine
doses distributed than in 2009-10 Coverage levels by census population estimates can provide estimates of doses
administered in the civilian non-institutionalized population
Moderate increase in childrenrsquos coverage since 2009
large increases since 2008
Similar coverage for adults as for 2009-10 trivalent
Coverage among adults ge65 years declining past two seasons
Racialethnic disparities among all adults persist
Non-Hispanic white adults significantly higher levels
Children nH-whites did not have higher coverage vs
other racialethnic groups in 2010-11
Wide variations among states
Maintained last seasonrsquos increases for pregnant women
and healthcare personnel 16
Limitations Self-reported vaccination not validated by medical records
Survey estimates may not be representative
BRFSS does not reach households with only cell phones (will do so next year)
Telephone survey response rates low
Representativeness of internet panel survey estimates needs further evaluation
Tracking trends by season complicated by multiple data sources
with different timeliness and possibly validity
Comparisons to 2009-10 season estimates complicated by unique
circumstances of pandemic and persons could have received
either 2009 H1N1 vaccine only seasonal vaccine only or both
17
Vaccination in the 2010-11 Influenza Season What did the US achieve
bull Despite the expected challenge of ldquoflu fatiguerdquo overallcopyvaccine coverage maintained last seasonrsquos increasescopyndash Significant increases in Hispanic and non-Hispanic black children
bull Multiple venues were accessed for vaccination
bull Challenges for the coming season
ndash Maintain the gains
ndash Improve vaccination coverage among adults with risk conditions
and older adults
ndash Improve full vaccination of children recommended for two doses
18
Source Biologics data
166-173m projected for 2011-12 (592011)
0
20
40
60
80
100
120
140
160
180 Ju
ly w
k 1
wk
2
wk
3
wk
4
Au
gu
st w
k 1
wk
2
wk
3
wk
4
Sep
tem
ber
wk
1
wk
2
wk
3
wk
4
Oct
ob
er w
k 1
wk
2
wk
3
wk
4
No
vem
ber
wk
1
wk
2
wk
3
wk
4
Dec
emb
er w
k 1
wk
2
wk
3
wk
4
Jan
ua
ry w
k 1
wk
2
wk
3
wk
4
Feb
rua
ry w
k 1
wk
2
wk
3
wk
4 C
um
ula
tiv
e n
um
be
r o
f d
ose
s d
istr
ibu
ted
in
mil
lio
ns
Month
Cumulative doses of influenza vaccines distributed by month 2004-05 -- 2011-12 seasons US
2011-12
2010-11
2009-10
2008-09
2007-08
2006-07
2005-06
2004-05
asymp1155m by 10072011
19
2011-12 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2011 and March or April 2012
bull National Flu Survey (NFS) November 2011 and March 2012
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
20
Preliminary Influenza Vaccination Coverage in Children 6mo-17yrs 2011-12 Season
Estimated coverage by October 15 2011 22-32
Higher than 17-20 by this date last season
Intended vaccination for children
44 to 56 already have or ldquodefinitely willrdquo be vaccinated
bull Consistent with 2010-11 coverage by end of May 2011 (51)
bull Adult estimates not yet available from the Behavioral Risk Factor Surveillance System (BRFSS)
bull Child estimates from the National Immunization Survey with vaccinations reported by parentsguardians without
provider confirmation Estimated coverage based on interviews conducted 912011-1082011 Projected coverage
including ldquodefinite intentrdquo based on interviews conducted 1012011-1082011 (n=2135)
21
Upcoming Data Releases
bull National Influenza Vaccination Week
(NIVW ) December 4-10 2011
ndash CDC media briefing Dec 5
bull Results from November 2011
ndash National Flu Survey
ndash Panel surveys
raquo Pregnant women
raquo Health Care Personnel
bull Monthly estimates for children and adults from NIS and BRFSS (schedule to be determined)
22
FluVaxView CDC Source for Influenza Vaccination Coverage Data
httpwwwcdcgovfluprofessionalsvaccinationvaccinecoveragehtm 23
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
80
Most children 6-11 months on 1112010 need 2 doses to be fully vaccinated
From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians without
provider confirmation prior season vaccinations not ascertained
69 63
52
62 62 60 57 55 53
33
22
13 12 12 13 8 10 10
6-11 mo
V
acc
ina
ted
70
60
50
40
30
20
10
0
ge 1 dosescopyge2 dosescopy
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
Age on November 1 2010
8
Influenza Vaccination (trivalent) Coverage by RaceEthnicity 2008-09 through 2010-11 Seasons
Group 2008-09
() 1
2009-10
() 2
2010-11
() 3
Adults by Raceethnicity
White non-Hispanic 435 441 432
Black non-Hispanic 350 328 342
Hispanic 284 293 323
Children by Raceethnicity
White non-Hispanic Not Available 432 485
Black non-Hispanic Not Available 370 508
Hispanic Not Available 469 551
Statistically significant difference compared to non-Hispanic whites (plt005)
1 BRFSS 2008-09 for adults
2 BRFSS and National 2009 H1N1 Flu Survey estimates 2009-10 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_0910estimateshtm
3 BRFSS and NIS estimates 2010-11 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
9
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
10
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
11
Estimated Influenza Vaccination (trivalent) Coverage Healthcare Personnel
V
acc
ina
ted
90
80
70
60
50
42 44 45
53 53
56
62 64
HP 2020 target is 90 percent
40
30
20
10
0
NHIS
BRFSS
NHFS
Internet Panel
2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season
Estimates from the National Health Interview Survey (NHIS) Behavioral Risk Factor Surveillance System (BRFSS) National 2009
H1N1 Flu Survey (NHFS) and internet panel surveys (MMWR August 19 2011 60(32)1073-1077)
12
Estimated Influenza Vaccination (trivalent) Coverage Pregnant Women
80
70
60
50
40
30 27
19
21
21
25
26
36
51 51
27 32
27
51
32
49
HP 2020 target is 80 percent
V
acc
ina
ted
BRFSS Pregnant BRFSS Not Pregnant PRAMS (10 states) NHFS Internet Panel 20
10
0 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season Behavioral Risk Factor Surveillance (BRFSS) data from December interviews only for women 18-44 years pregnant or not pregnant when
interviewed Differences in influenza vaccination coverage between pregnant and not pregnant women were statistically significant
(plt005) only for the 2009-10 and 2010-11 seasons Other estimates for pregnant women from PRAMS (MMWR December 3 2010
59(47)1541-1545) NHFS (Ding et al Am J Obstetrics amp Gynecology June 2011 Supplement) and an internet panel survey (MMWR August
19 2011 60(32)1078-1082)
13
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 201160(23)781-785
Doctors officeHMO
HospitalED
Other clinichealth center
Health Department
Store
Workplace
Senior reccomm center
School
Other non-medical
0 10 20 30 40 50 60
18+ yrs
18-49
50-64
65+
40 18+ yrs
18 18+ yrs
17 18+ yrs
26 65+
52 65+
26 18-49
of vaccinated by place eg supermarket or drug store
BRFSS January-March 2011 data from 46 states and District of Columbia 14
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 2011
Doctorrsquos office is most important medical setting
Workplace and store important non-medical settings
Increase in store vaccination (184) compared to
1998-99 (5) and 2006-07 (7)
Increases in persons vaccinated since 2006-07
Doctorrsquos office 28 million (2006-07) to 37 million (2010-11)
Store 6 million (2006-07) to 17 million (2010-11)
vaccinated in non-medical settings higher for
whites (44) vs blacks (29) Hispanics (34)
Attended college (47) vs lt high school education (28)
15
Summary 44 million more seasonal (trivalent) influenza vaccine
doses distributed than in 2009-10 Coverage levels by census population estimates can provide estimates of doses
administered in the civilian non-institutionalized population
Moderate increase in childrenrsquos coverage since 2009
large increases since 2008
Similar coverage for adults as for 2009-10 trivalent
Coverage among adults ge65 years declining past two seasons
Racialethnic disparities among all adults persist
Non-Hispanic white adults significantly higher levels
Children nH-whites did not have higher coverage vs
other racialethnic groups in 2010-11
Wide variations among states
Maintained last seasonrsquos increases for pregnant women
and healthcare personnel 16
Limitations Self-reported vaccination not validated by medical records
Survey estimates may not be representative
BRFSS does not reach households with only cell phones (will do so next year)
Telephone survey response rates low
Representativeness of internet panel survey estimates needs further evaluation
Tracking trends by season complicated by multiple data sources
with different timeliness and possibly validity
Comparisons to 2009-10 season estimates complicated by unique
circumstances of pandemic and persons could have received
either 2009 H1N1 vaccine only seasonal vaccine only or both
17
Vaccination in the 2010-11 Influenza Season What did the US achieve
bull Despite the expected challenge of ldquoflu fatiguerdquo overallcopyvaccine coverage maintained last seasonrsquos increasescopyndash Significant increases in Hispanic and non-Hispanic black children
bull Multiple venues were accessed for vaccination
bull Challenges for the coming season
ndash Maintain the gains
ndash Improve vaccination coverage among adults with risk conditions
and older adults
ndash Improve full vaccination of children recommended for two doses
18
Source Biologics data
166-173m projected for 2011-12 (592011)
0
20
40
60
80
100
120
140
160
180 Ju
ly w
k 1
wk
2
wk
3
wk
4
Au
gu
st w
k 1
wk
2
wk
3
wk
4
Sep
tem
ber
wk
1
wk
2
wk
3
wk
4
Oct
ob
er w
k 1
wk
2
wk
3
wk
4
No
vem
ber
wk
1
wk
2
wk
3
wk
4
Dec
emb
er w
k 1
wk
2
wk
3
wk
4
Jan
ua
ry w
k 1
wk
2
wk
3
wk
4
Feb
rua
ry w
k 1
wk
2
wk
3
wk
4 C
um
ula
tiv
e n
um
be
r o
f d
ose
s d
istr
ibu
ted
in
mil
lio
ns
Month
Cumulative doses of influenza vaccines distributed by month 2004-05 -- 2011-12 seasons US
2011-12
2010-11
2009-10
2008-09
2007-08
2006-07
2005-06
2004-05
asymp1155m by 10072011
19
2011-12 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2011 and March or April 2012
bull National Flu Survey (NFS) November 2011 and March 2012
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
20
Preliminary Influenza Vaccination Coverage in Children 6mo-17yrs 2011-12 Season
Estimated coverage by October 15 2011 22-32
Higher than 17-20 by this date last season
Intended vaccination for children
44 to 56 already have or ldquodefinitely willrdquo be vaccinated
bull Consistent with 2010-11 coverage by end of May 2011 (51)
bull Adult estimates not yet available from the Behavioral Risk Factor Surveillance System (BRFSS)
bull Child estimates from the National Immunization Survey with vaccinations reported by parentsguardians without
provider confirmation Estimated coverage based on interviews conducted 912011-1082011 Projected coverage
including ldquodefinite intentrdquo based on interviews conducted 1012011-1082011 (n=2135)
21
Upcoming Data Releases
bull National Influenza Vaccination Week
(NIVW ) December 4-10 2011
ndash CDC media briefing Dec 5
bull Results from November 2011
ndash National Flu Survey
ndash Panel surveys
raquo Pregnant women
raquo Health Care Personnel
bull Monthly estimates for children and adults from NIS and BRFSS (schedule to be determined)
22
FluVaxView CDC Source for Influenza Vaccination Coverage Data
httpwwwcdcgovfluprofessionalsvaccinationvaccinecoveragehtm 23
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Influenza Vaccination (trivalent) Coverage by RaceEthnicity 2008-09 through 2010-11 Seasons
Group 2008-09
() 1
2009-10
() 2
2010-11
() 3
Adults by Raceethnicity
White non-Hispanic 435 441 432
Black non-Hispanic 350 328 342
Hispanic 284 293 323
Children by Raceethnicity
White non-Hispanic Not Available 432 485
Black non-Hispanic Not Available 370 508
Hispanic Not Available 469 551
Statistically significant difference compared to non-Hispanic whites (plt005)
1 BRFSS 2008-09 for adults
2 BRFSS and National 2009 H1N1 Flu Survey estimates 2009-10 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_0910estimateshtm
3 BRFSS and NIS estimates 2010-11 Online at
httpwwwcdcgovfluprofessionalsvaccinationcoverage_1011estimateshtm
9
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
10
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
11
Estimated Influenza Vaccination (trivalent) Coverage Healthcare Personnel
V
acc
ina
ted
90
80
70
60
50
42 44 45
53 53
56
62 64
HP 2020 target is 90 percent
40
30
20
10
0
NHIS
BRFSS
NHFS
Internet Panel
2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season
Estimates from the National Health Interview Survey (NHIS) Behavioral Risk Factor Surveillance System (BRFSS) National 2009
H1N1 Flu Survey (NHFS) and internet panel surveys (MMWR August 19 2011 60(32)1073-1077)
12
Estimated Influenza Vaccination (trivalent) Coverage Pregnant Women
80
70
60
50
40
30 27
19
21
21
25
26
36
51 51
27 32
27
51
32
49
HP 2020 target is 80 percent
V
acc
ina
ted
BRFSS Pregnant BRFSS Not Pregnant PRAMS (10 states) NHFS Internet Panel 20
10
0 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season Behavioral Risk Factor Surveillance (BRFSS) data from December interviews only for women 18-44 years pregnant or not pregnant when
interviewed Differences in influenza vaccination coverage between pregnant and not pregnant women were statistically significant
(plt005) only for the 2009-10 and 2010-11 seasons Other estimates for pregnant women from PRAMS (MMWR December 3 2010
59(47)1541-1545) NHFS (Ding et al Am J Obstetrics amp Gynecology June 2011 Supplement) and an internet panel survey (MMWR August
19 2011 60(32)1078-1082)
13
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 201160(23)781-785
Doctors officeHMO
HospitalED
Other clinichealth center
Health Department
Store
Workplace
Senior reccomm center
School
Other non-medical
0 10 20 30 40 50 60
18+ yrs
18-49
50-64
65+
40 18+ yrs
18 18+ yrs
17 18+ yrs
26 65+
52 65+
26 18-49
of vaccinated by place eg supermarket or drug store
BRFSS January-March 2011 data from 46 states and District of Columbia 14
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 2011
Doctorrsquos office is most important medical setting
Workplace and store important non-medical settings
Increase in store vaccination (184) compared to
1998-99 (5) and 2006-07 (7)
Increases in persons vaccinated since 2006-07
Doctorrsquos office 28 million (2006-07) to 37 million (2010-11)
Store 6 million (2006-07) to 17 million (2010-11)
vaccinated in non-medical settings higher for
whites (44) vs blacks (29) Hispanics (34)
Attended college (47) vs lt high school education (28)
15
Summary 44 million more seasonal (trivalent) influenza vaccine
doses distributed than in 2009-10 Coverage levels by census population estimates can provide estimates of doses
administered in the civilian non-institutionalized population
Moderate increase in childrenrsquos coverage since 2009
large increases since 2008
Similar coverage for adults as for 2009-10 trivalent
Coverage among adults ge65 years declining past two seasons
Racialethnic disparities among all adults persist
Non-Hispanic white adults significantly higher levels
Children nH-whites did not have higher coverage vs
other racialethnic groups in 2010-11
Wide variations among states
Maintained last seasonrsquos increases for pregnant women
and healthcare personnel 16
Limitations Self-reported vaccination not validated by medical records
Survey estimates may not be representative
BRFSS does not reach households with only cell phones (will do so next year)
Telephone survey response rates low
Representativeness of internet panel survey estimates needs further evaluation
Tracking trends by season complicated by multiple data sources
with different timeliness and possibly validity
Comparisons to 2009-10 season estimates complicated by unique
circumstances of pandemic and persons could have received
either 2009 H1N1 vaccine only seasonal vaccine only or both
17
Vaccination in the 2010-11 Influenza Season What did the US achieve
bull Despite the expected challenge of ldquoflu fatiguerdquo overallcopyvaccine coverage maintained last seasonrsquos increasescopyndash Significant increases in Hispanic and non-Hispanic black children
bull Multiple venues were accessed for vaccination
bull Challenges for the coming season
ndash Maintain the gains
ndash Improve vaccination coverage among adults with risk conditions
and older adults
ndash Improve full vaccination of children recommended for two doses
18
Source Biologics data
166-173m projected for 2011-12 (592011)
0
20
40
60
80
100
120
140
160
180 Ju
ly w
k 1
wk
2
wk
3
wk
4
Au
gu
st w
k 1
wk
2
wk
3
wk
4
Sep
tem
ber
wk
1
wk
2
wk
3
wk
4
Oct
ob
er w
k 1
wk
2
wk
3
wk
4
No
vem
ber
wk
1
wk
2
wk
3
wk
4
Dec
emb
er w
k 1
wk
2
wk
3
wk
4
Jan
ua
ry w
k 1
wk
2
wk
3
wk
4
Feb
rua
ry w
k 1
wk
2
wk
3
wk
4 C
um
ula
tiv
e n
um
be
r o
f d
ose
s d
istr
ibu
ted
in
mil
lio
ns
Month
Cumulative doses of influenza vaccines distributed by month 2004-05 -- 2011-12 seasons US
2011-12
2010-11
2009-10
2008-09
2007-08
2006-07
2005-06
2004-05
asymp1155m by 10072011
19
2011-12 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2011 and March or April 2012
bull National Flu Survey (NFS) November 2011 and March 2012
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
20
Preliminary Influenza Vaccination Coverage in Children 6mo-17yrs 2011-12 Season
Estimated coverage by October 15 2011 22-32
Higher than 17-20 by this date last season
Intended vaccination for children
44 to 56 already have or ldquodefinitely willrdquo be vaccinated
bull Consistent with 2010-11 coverage by end of May 2011 (51)
bull Adult estimates not yet available from the Behavioral Risk Factor Surveillance System (BRFSS)
bull Child estimates from the National Immunization Survey with vaccinations reported by parentsguardians without
provider confirmation Estimated coverage based on interviews conducted 912011-1082011 Projected coverage
including ldquodefinite intentrdquo based on interviews conducted 1012011-1082011 (n=2135)
21
Upcoming Data Releases
bull National Influenza Vaccination Week
(NIVW ) December 4-10 2011
ndash CDC media briefing Dec 5
bull Results from November 2011
ndash National Flu Survey
ndash Panel surveys
raquo Pregnant women
raquo Health Care Personnel
bull Monthly estimates for children and adults from NIS and BRFSS (schedule to be determined)
22
FluVaxView CDC Source for Influenza Vaccination Coverage Data
httpwwwcdcgovfluprofessionalsvaccinationvaccinecoveragehtm 23
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
10
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
11
Estimated Influenza Vaccination (trivalent) Coverage Healthcare Personnel
V
acc
ina
ted
90
80
70
60
50
42 44 45
53 53
56
62 64
HP 2020 target is 90 percent
40
30
20
10
0
NHIS
BRFSS
NHFS
Internet Panel
2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season
Estimates from the National Health Interview Survey (NHIS) Behavioral Risk Factor Surveillance System (BRFSS) National 2009
H1N1 Flu Survey (NHFS) and internet panel surveys (MMWR August 19 2011 60(32)1073-1077)
12
Estimated Influenza Vaccination (trivalent) Coverage Pregnant Women
80
70
60
50
40
30 27
19
21
21
25
26
36
51 51
27 32
27
51
32
49
HP 2020 target is 80 percent
V
acc
ina
ted
BRFSS Pregnant BRFSS Not Pregnant PRAMS (10 states) NHFS Internet Panel 20
10
0 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season Behavioral Risk Factor Surveillance (BRFSS) data from December interviews only for women 18-44 years pregnant or not pregnant when
interviewed Differences in influenza vaccination coverage between pregnant and not pregnant women were statistically significant
(plt005) only for the 2009-10 and 2010-11 seasons Other estimates for pregnant women from PRAMS (MMWR December 3 2010
59(47)1541-1545) NHFS (Ding et al Am J Obstetrics amp Gynecology June 2011 Supplement) and an internet panel survey (MMWR August
19 2011 60(32)1078-1082)
13
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 201160(23)781-785
Doctors officeHMO
HospitalED
Other clinichealth center
Health Department
Store
Workplace
Senior reccomm center
School
Other non-medical
0 10 20 30 40 50 60
18+ yrs
18-49
50-64
65+
40 18+ yrs
18 18+ yrs
17 18+ yrs
26 65+
52 65+
26 18-49
of vaccinated by place eg supermarket or drug store
BRFSS January-March 2011 data from 46 states and District of Columbia 14
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 2011
Doctorrsquos office is most important medical setting
Workplace and store important non-medical settings
Increase in store vaccination (184) compared to
1998-99 (5) and 2006-07 (7)
Increases in persons vaccinated since 2006-07
Doctorrsquos office 28 million (2006-07) to 37 million (2010-11)
Store 6 million (2006-07) to 17 million (2010-11)
vaccinated in non-medical settings higher for
whites (44) vs blacks (29) Hispanics (34)
Attended college (47) vs lt high school education (28)
15
Summary 44 million more seasonal (trivalent) influenza vaccine
doses distributed than in 2009-10 Coverage levels by census population estimates can provide estimates of doses
administered in the civilian non-institutionalized population
Moderate increase in childrenrsquos coverage since 2009
large increases since 2008
Similar coverage for adults as for 2009-10 trivalent
Coverage among adults ge65 years declining past two seasons
Racialethnic disparities among all adults persist
Non-Hispanic white adults significantly higher levels
Children nH-whites did not have higher coverage vs
other racialethnic groups in 2010-11
Wide variations among states
Maintained last seasonrsquos increases for pregnant women
and healthcare personnel 16
Limitations Self-reported vaccination not validated by medical records
Survey estimates may not be representative
BRFSS does not reach households with only cell phones (will do so next year)
Telephone survey response rates low
Representativeness of internet panel survey estimates needs further evaluation
Tracking trends by season complicated by multiple data sources
with different timeliness and possibly validity
Comparisons to 2009-10 season estimates complicated by unique
circumstances of pandemic and persons could have received
either 2009 H1N1 vaccine only seasonal vaccine only or both
17
Vaccination in the 2010-11 Influenza Season What did the US achieve
bull Despite the expected challenge of ldquoflu fatiguerdquo overallcopyvaccine coverage maintained last seasonrsquos increasescopyndash Significant increases in Hispanic and non-Hispanic black children
bull Multiple venues were accessed for vaccination
bull Challenges for the coming season
ndash Maintain the gains
ndash Improve vaccination coverage among adults with risk conditions
and older adults
ndash Improve full vaccination of children recommended for two doses
18
Source Biologics data
166-173m projected for 2011-12 (592011)
0
20
40
60
80
100
120
140
160
180 Ju
ly w
k 1
wk
2
wk
3
wk
4
Au
gu
st w
k 1
wk
2
wk
3
wk
4
Sep
tem
ber
wk
1
wk
2
wk
3
wk
4
Oct
ob
er w
k 1
wk
2
wk
3
wk
4
No
vem
ber
wk
1
wk
2
wk
3
wk
4
Dec
emb
er w
k 1
wk
2
wk
3
wk
4
Jan
ua
ry w
k 1
wk
2
wk
3
wk
4
Feb
rua
ry w
k 1
wk
2
wk
3
wk
4 C
um
ula
tiv
e n
um
be
r o
f d
ose
s d
istr
ibu
ted
in
mil
lio
ns
Month
Cumulative doses of influenza vaccines distributed by month 2004-05 -- 2011-12 seasons US
2011-12
2010-11
2009-10
2008-09
2007-08
2006-07
2005-06
2004-05
asymp1155m by 10072011
19
2011-12 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2011 and March or April 2012
bull National Flu Survey (NFS) November 2011 and March 2012
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
20
Preliminary Influenza Vaccination Coverage in Children 6mo-17yrs 2011-12 Season
Estimated coverage by October 15 2011 22-32
Higher than 17-20 by this date last season
Intended vaccination for children
44 to 56 already have or ldquodefinitely willrdquo be vaccinated
bull Consistent with 2010-11 coverage by end of May 2011 (51)
bull Adult estimates not yet available from the Behavioral Risk Factor Surveillance System (BRFSS)
bull Child estimates from the National Immunization Survey with vaccinations reported by parentsguardians without
provider confirmation Estimated coverage based on interviews conducted 912011-1082011 Projected coverage
including ldquodefinite intentrdquo based on interviews conducted 1012011-1082011 (n=2135)
21
Upcoming Data Releases
bull National Influenza Vaccination Week
(NIVW ) December 4-10 2011
ndash CDC media briefing Dec 5
bull Results from November 2011
ndash National Flu Survey
ndash Panel surveys
raquo Pregnant women
raquo Health Care Personnel
bull Monthly estimates for children and adults from NIS and BRFSS (schedule to be determined)
22
FluVaxView CDC Source for Influenza Vaccination Coverage Data
httpwwwcdcgovfluprofessionalsvaccinationvaccinecoveragehtm 23
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
11
Estimated Influenza Vaccination (trivalent) Coverage Healthcare Personnel
V
acc
ina
ted
90
80
70
60
50
42 44 45
53 53
56
62 64
HP 2020 target is 90 percent
40
30
20
10
0
NHIS
BRFSS
NHFS
Internet Panel
2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season
Estimates from the National Health Interview Survey (NHIS) Behavioral Risk Factor Surveillance System (BRFSS) National 2009
H1N1 Flu Survey (NHFS) and internet panel surveys (MMWR August 19 2011 60(32)1073-1077)
12
Estimated Influenza Vaccination (trivalent) Coverage Pregnant Women
80
70
60
50
40
30 27
19
21
21
25
26
36
51 51
27 32
27
51
32
49
HP 2020 target is 80 percent
V
acc
ina
ted
BRFSS Pregnant BRFSS Not Pregnant PRAMS (10 states) NHFS Internet Panel 20
10
0 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season Behavioral Risk Factor Surveillance (BRFSS) data from December interviews only for women 18-44 years pregnant or not pregnant when
interviewed Differences in influenza vaccination coverage between pregnant and not pregnant women were statistically significant
(plt005) only for the 2009-10 and 2010-11 seasons Other estimates for pregnant women from PRAMS (MMWR December 3 2010
59(47)1541-1545) NHFS (Ding et al Am J Obstetrics amp Gynecology June 2011 Supplement) and an internet panel survey (MMWR August
19 2011 60(32)1078-1082)
13
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 201160(23)781-785
Doctors officeHMO
HospitalED
Other clinichealth center
Health Department
Store
Workplace
Senior reccomm center
School
Other non-medical
0 10 20 30 40 50 60
18+ yrs
18-49
50-64
65+
40 18+ yrs
18 18+ yrs
17 18+ yrs
26 65+
52 65+
26 18-49
of vaccinated by place eg supermarket or drug store
BRFSS January-March 2011 data from 46 states and District of Columbia 14
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 2011
Doctorrsquos office is most important medical setting
Workplace and store important non-medical settings
Increase in store vaccination (184) compared to
1998-99 (5) and 2006-07 (7)
Increases in persons vaccinated since 2006-07
Doctorrsquos office 28 million (2006-07) to 37 million (2010-11)
Store 6 million (2006-07) to 17 million (2010-11)
vaccinated in non-medical settings higher for
whites (44) vs blacks (29) Hispanics (34)
Attended college (47) vs lt high school education (28)
15
Summary 44 million more seasonal (trivalent) influenza vaccine
doses distributed than in 2009-10 Coverage levels by census population estimates can provide estimates of doses
administered in the civilian non-institutionalized population
Moderate increase in childrenrsquos coverage since 2009
large increases since 2008
Similar coverage for adults as for 2009-10 trivalent
Coverage among adults ge65 years declining past two seasons
Racialethnic disparities among all adults persist
Non-Hispanic white adults significantly higher levels
Children nH-whites did not have higher coverage vs
other racialethnic groups in 2010-11
Wide variations among states
Maintained last seasonrsquos increases for pregnant women
and healthcare personnel 16
Limitations Self-reported vaccination not validated by medical records
Survey estimates may not be representative
BRFSS does not reach households with only cell phones (will do so next year)
Telephone survey response rates low
Representativeness of internet panel survey estimates needs further evaluation
Tracking trends by season complicated by multiple data sources
with different timeliness and possibly validity
Comparisons to 2009-10 season estimates complicated by unique
circumstances of pandemic and persons could have received
either 2009 H1N1 vaccine only seasonal vaccine only or both
17
Vaccination in the 2010-11 Influenza Season What did the US achieve
bull Despite the expected challenge of ldquoflu fatiguerdquo overallcopyvaccine coverage maintained last seasonrsquos increasescopyndash Significant increases in Hispanic and non-Hispanic black children
bull Multiple venues were accessed for vaccination
bull Challenges for the coming season
ndash Maintain the gains
ndash Improve vaccination coverage among adults with risk conditions
and older adults
ndash Improve full vaccination of children recommended for two doses
18
Source Biologics data
166-173m projected for 2011-12 (592011)
0
20
40
60
80
100
120
140
160
180 Ju
ly w
k 1
wk
2
wk
3
wk
4
Au
gu
st w
k 1
wk
2
wk
3
wk
4
Sep
tem
ber
wk
1
wk
2
wk
3
wk
4
Oct
ob
er w
k 1
wk
2
wk
3
wk
4
No
vem
ber
wk
1
wk
2
wk
3
wk
4
Dec
emb
er w
k 1
wk
2
wk
3
wk
4
Jan
ua
ry w
k 1
wk
2
wk
3
wk
4
Feb
rua
ry w
k 1
wk
2
wk
3
wk
4 C
um
ula
tiv
e n
um
be
r o
f d
ose
s d
istr
ibu
ted
in
mil
lio
ns
Month
Cumulative doses of influenza vaccines distributed by month 2004-05 -- 2011-12 seasons US
2011-12
2010-11
2009-10
2008-09
2007-08
2006-07
2005-06
2004-05
asymp1155m by 10072011
19
2011-12 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2011 and March or April 2012
bull National Flu Survey (NFS) November 2011 and March 2012
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
20
Preliminary Influenza Vaccination Coverage in Children 6mo-17yrs 2011-12 Season
Estimated coverage by October 15 2011 22-32
Higher than 17-20 by this date last season
Intended vaccination for children
44 to 56 already have or ldquodefinitely willrdquo be vaccinated
bull Consistent with 2010-11 coverage by end of May 2011 (51)
bull Adult estimates not yet available from the Behavioral Risk Factor Surveillance System (BRFSS)
bull Child estimates from the National Immunization Survey with vaccinations reported by parentsguardians without
provider confirmation Estimated coverage based on interviews conducted 912011-1082011 Projected coverage
including ldquodefinite intentrdquo based on interviews conducted 1012011-1082011 (n=2135)
21
Upcoming Data Releases
bull National Influenza Vaccination Week
(NIVW ) December 4-10 2011
ndash CDC media briefing Dec 5
bull Results from November 2011
ndash National Flu Survey
ndash Panel surveys
raquo Pregnant women
raquo Health Care Personnel
bull Monthly estimates for children and adults from NIS and BRFSS (schedule to be determined)
22
FluVaxView CDC Source for Influenza Vaccination Coverage Data
httpwwwcdcgovfluprofessionalsvaccinationvaccinecoveragehtm 23
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Estimated Influenza Vaccination (trivalent) Coverage Healthcare Personnel
V
acc
ina
ted
90
80
70
60
50
42 44 45
53 53
56
62 64
HP 2020 target is 90 percent
40
30
20
10
0
NHIS
BRFSS
NHFS
Internet Panel
2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season
Estimates from the National Health Interview Survey (NHIS) Behavioral Risk Factor Surveillance System (BRFSS) National 2009
H1N1 Flu Survey (NHFS) and internet panel surveys (MMWR August 19 2011 60(32)1073-1077)
12
Estimated Influenza Vaccination (trivalent) Coverage Pregnant Women
80
70
60
50
40
30 27
19
21
21
25
26
36
51 51
27 32
27
51
32
49
HP 2020 target is 80 percent
V
acc
ina
ted
BRFSS Pregnant BRFSS Not Pregnant PRAMS (10 states) NHFS Internet Panel 20
10
0 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season Behavioral Risk Factor Surveillance (BRFSS) data from December interviews only for women 18-44 years pregnant or not pregnant when
interviewed Differences in influenza vaccination coverage between pregnant and not pregnant women were statistically significant
(plt005) only for the 2009-10 and 2010-11 seasons Other estimates for pregnant women from PRAMS (MMWR December 3 2010
59(47)1541-1545) NHFS (Ding et al Am J Obstetrics amp Gynecology June 2011 Supplement) and an internet panel survey (MMWR August
19 2011 60(32)1078-1082)
13
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 201160(23)781-785
Doctors officeHMO
HospitalED
Other clinichealth center
Health Department
Store
Workplace
Senior reccomm center
School
Other non-medical
0 10 20 30 40 50 60
18+ yrs
18-49
50-64
65+
40 18+ yrs
18 18+ yrs
17 18+ yrs
26 65+
52 65+
26 18-49
of vaccinated by place eg supermarket or drug store
BRFSS January-March 2011 data from 46 states and District of Columbia 14
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 2011
Doctorrsquos office is most important medical setting
Workplace and store important non-medical settings
Increase in store vaccination (184) compared to
1998-99 (5) and 2006-07 (7)
Increases in persons vaccinated since 2006-07
Doctorrsquos office 28 million (2006-07) to 37 million (2010-11)
Store 6 million (2006-07) to 17 million (2010-11)
vaccinated in non-medical settings higher for
whites (44) vs blacks (29) Hispanics (34)
Attended college (47) vs lt high school education (28)
15
Summary 44 million more seasonal (trivalent) influenza vaccine
doses distributed than in 2009-10 Coverage levels by census population estimates can provide estimates of doses
administered in the civilian non-institutionalized population
Moderate increase in childrenrsquos coverage since 2009
large increases since 2008
Similar coverage for adults as for 2009-10 trivalent
Coverage among adults ge65 years declining past two seasons
Racialethnic disparities among all adults persist
Non-Hispanic white adults significantly higher levels
Children nH-whites did not have higher coverage vs
other racialethnic groups in 2010-11
Wide variations among states
Maintained last seasonrsquos increases for pregnant women
and healthcare personnel 16
Limitations Self-reported vaccination not validated by medical records
Survey estimates may not be representative
BRFSS does not reach households with only cell phones (will do so next year)
Telephone survey response rates low
Representativeness of internet panel survey estimates needs further evaluation
Tracking trends by season complicated by multiple data sources
with different timeliness and possibly validity
Comparisons to 2009-10 season estimates complicated by unique
circumstances of pandemic and persons could have received
either 2009 H1N1 vaccine only seasonal vaccine only or both
17
Vaccination in the 2010-11 Influenza Season What did the US achieve
bull Despite the expected challenge of ldquoflu fatiguerdquo overallcopyvaccine coverage maintained last seasonrsquos increasescopyndash Significant increases in Hispanic and non-Hispanic black children
bull Multiple venues were accessed for vaccination
bull Challenges for the coming season
ndash Maintain the gains
ndash Improve vaccination coverage among adults with risk conditions
and older adults
ndash Improve full vaccination of children recommended for two doses
18
Source Biologics data
166-173m projected for 2011-12 (592011)
0
20
40
60
80
100
120
140
160
180 Ju
ly w
k 1
wk
2
wk
3
wk
4
Au
gu
st w
k 1
wk
2
wk
3
wk
4
Sep
tem
ber
wk
1
wk
2
wk
3
wk
4
Oct
ob
er w
k 1
wk
2
wk
3
wk
4
No
vem
ber
wk
1
wk
2
wk
3
wk
4
Dec
emb
er w
k 1
wk
2
wk
3
wk
4
Jan
ua
ry w
k 1
wk
2
wk
3
wk
4
Feb
rua
ry w
k 1
wk
2
wk
3
wk
4 C
um
ula
tiv
e n
um
be
r o
f d
ose
s d
istr
ibu
ted
in
mil
lio
ns
Month
Cumulative doses of influenza vaccines distributed by month 2004-05 -- 2011-12 seasons US
2011-12
2010-11
2009-10
2008-09
2007-08
2006-07
2005-06
2004-05
asymp1155m by 10072011
19
2011-12 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2011 and March or April 2012
bull National Flu Survey (NFS) November 2011 and March 2012
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
20
Preliminary Influenza Vaccination Coverage in Children 6mo-17yrs 2011-12 Season
Estimated coverage by October 15 2011 22-32
Higher than 17-20 by this date last season
Intended vaccination for children
44 to 56 already have or ldquodefinitely willrdquo be vaccinated
bull Consistent with 2010-11 coverage by end of May 2011 (51)
bull Adult estimates not yet available from the Behavioral Risk Factor Surveillance System (BRFSS)
bull Child estimates from the National Immunization Survey with vaccinations reported by parentsguardians without
provider confirmation Estimated coverage based on interviews conducted 912011-1082011 Projected coverage
including ldquodefinite intentrdquo based on interviews conducted 1012011-1082011 (n=2135)
21
Upcoming Data Releases
bull National Influenza Vaccination Week
(NIVW ) December 4-10 2011
ndash CDC media briefing Dec 5
bull Results from November 2011
ndash National Flu Survey
ndash Panel surveys
raquo Pregnant women
raquo Health Care Personnel
bull Monthly estimates for children and adults from NIS and BRFSS (schedule to be determined)
22
FluVaxView CDC Source for Influenza Vaccination Coverage Data
httpwwwcdcgovfluprofessionalsvaccinationvaccinecoveragehtm 23
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Estimated Influenza Vaccination (trivalent) Coverage Pregnant Women
80
70
60
50
40
30 27
19
21
21
25
26
36
51 51
27 32
27
51
32
49
HP 2020 target is 80 percent
V
acc
ina
ted
BRFSS Pregnant BRFSS Not Pregnant PRAMS (10 states) NHFS Internet Panel 20
10
0 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11
Influenza Season Behavioral Risk Factor Surveillance (BRFSS) data from December interviews only for women 18-44 years pregnant or not pregnant when
interviewed Differences in influenza vaccination coverage between pregnant and not pregnant women were statistically significant
(plt005) only for the 2009-10 and 2010-11 seasons Other estimates for pregnant women from PRAMS (MMWR December 3 2010
59(47)1541-1545) NHFS (Ding et al Am J Obstetrics amp Gynecology June 2011 Supplement) and an internet panel survey (MMWR August
19 2011 60(32)1078-1082)
13
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 201160(23)781-785
Doctors officeHMO
HospitalED
Other clinichealth center
Health Department
Store
Workplace
Senior reccomm center
School
Other non-medical
0 10 20 30 40 50 60
18+ yrs
18-49
50-64
65+
40 18+ yrs
18 18+ yrs
17 18+ yrs
26 65+
52 65+
26 18-49
of vaccinated by place eg supermarket or drug store
BRFSS January-March 2011 data from 46 states and District of Columbia 14
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 2011
Doctorrsquos office is most important medical setting
Workplace and store important non-medical settings
Increase in store vaccination (184) compared to
1998-99 (5) and 2006-07 (7)
Increases in persons vaccinated since 2006-07
Doctorrsquos office 28 million (2006-07) to 37 million (2010-11)
Store 6 million (2006-07) to 17 million (2010-11)
vaccinated in non-medical settings higher for
whites (44) vs blacks (29) Hispanics (34)
Attended college (47) vs lt high school education (28)
15
Summary 44 million more seasonal (trivalent) influenza vaccine
doses distributed than in 2009-10 Coverage levels by census population estimates can provide estimates of doses
administered in the civilian non-institutionalized population
Moderate increase in childrenrsquos coverage since 2009
large increases since 2008
Similar coverage for adults as for 2009-10 trivalent
Coverage among adults ge65 years declining past two seasons
Racialethnic disparities among all adults persist
Non-Hispanic white adults significantly higher levels
Children nH-whites did not have higher coverage vs
other racialethnic groups in 2010-11
Wide variations among states
Maintained last seasonrsquos increases for pregnant women
and healthcare personnel 16
Limitations Self-reported vaccination not validated by medical records
Survey estimates may not be representative
BRFSS does not reach households with only cell phones (will do so next year)
Telephone survey response rates low
Representativeness of internet panel survey estimates needs further evaluation
Tracking trends by season complicated by multiple data sources
with different timeliness and possibly validity
Comparisons to 2009-10 season estimates complicated by unique
circumstances of pandemic and persons could have received
either 2009 H1N1 vaccine only seasonal vaccine only or both
17
Vaccination in the 2010-11 Influenza Season What did the US achieve
bull Despite the expected challenge of ldquoflu fatiguerdquo overallcopyvaccine coverage maintained last seasonrsquos increasescopyndash Significant increases in Hispanic and non-Hispanic black children
bull Multiple venues were accessed for vaccination
bull Challenges for the coming season
ndash Maintain the gains
ndash Improve vaccination coverage among adults with risk conditions
and older adults
ndash Improve full vaccination of children recommended for two doses
18
Source Biologics data
166-173m projected for 2011-12 (592011)
0
20
40
60
80
100
120
140
160
180 Ju
ly w
k 1
wk
2
wk
3
wk
4
Au
gu
st w
k 1
wk
2
wk
3
wk
4
Sep
tem
ber
wk
1
wk
2
wk
3
wk
4
Oct
ob
er w
k 1
wk
2
wk
3
wk
4
No
vem
ber
wk
1
wk
2
wk
3
wk
4
Dec
emb
er w
k 1
wk
2
wk
3
wk
4
Jan
ua
ry w
k 1
wk
2
wk
3
wk
4
Feb
rua
ry w
k 1
wk
2
wk
3
wk
4 C
um
ula
tiv
e n
um
be
r o
f d
ose
s d
istr
ibu
ted
in
mil
lio
ns
Month
Cumulative doses of influenza vaccines distributed by month 2004-05 -- 2011-12 seasons US
2011-12
2010-11
2009-10
2008-09
2007-08
2006-07
2005-06
2004-05
asymp1155m by 10072011
19
2011-12 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2011 and March or April 2012
bull National Flu Survey (NFS) November 2011 and March 2012
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
20
Preliminary Influenza Vaccination Coverage in Children 6mo-17yrs 2011-12 Season
Estimated coverage by October 15 2011 22-32
Higher than 17-20 by this date last season
Intended vaccination for children
44 to 56 already have or ldquodefinitely willrdquo be vaccinated
bull Consistent with 2010-11 coverage by end of May 2011 (51)
bull Adult estimates not yet available from the Behavioral Risk Factor Surveillance System (BRFSS)
bull Child estimates from the National Immunization Survey with vaccinations reported by parentsguardians without
provider confirmation Estimated coverage based on interviews conducted 912011-1082011 Projected coverage
including ldquodefinite intentrdquo based on interviews conducted 1012011-1082011 (n=2135)
21
Upcoming Data Releases
bull National Influenza Vaccination Week
(NIVW ) December 4-10 2011
ndash CDC media briefing Dec 5
bull Results from November 2011
ndash National Flu Survey
ndash Panel surveys
raquo Pregnant women
raquo Health Care Personnel
bull Monthly estimates for children and adults from NIS and BRFSS (schedule to be determined)
22
FluVaxView CDC Source for Influenza Vaccination Coverage Data
httpwwwcdcgovfluprofessionalsvaccinationvaccinecoveragehtm 23
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 201160(23)781-785
Doctors officeHMO
HospitalED
Other clinichealth center
Health Department
Store
Workplace
Senior reccomm center
School
Other non-medical
0 10 20 30 40 50 60
18+ yrs
18-49
50-64
65+
40 18+ yrs
18 18+ yrs
17 18+ yrs
26 65+
52 65+
26 18-49
of vaccinated by place eg supermarket or drug store
BRFSS January-March 2011 data from 46 states and District of Columbia 14
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 2011
Doctorrsquos office is most important medical setting
Workplace and store important non-medical settings
Increase in store vaccination (184) compared to
1998-99 (5) and 2006-07 (7)
Increases in persons vaccinated since 2006-07
Doctorrsquos office 28 million (2006-07) to 37 million (2010-11)
Store 6 million (2006-07) to 17 million (2010-11)
vaccinated in non-medical settings higher for
whites (44) vs blacks (29) Hispanics (34)
Attended college (47) vs lt high school education (28)
15
Summary 44 million more seasonal (trivalent) influenza vaccine
doses distributed than in 2009-10 Coverage levels by census population estimates can provide estimates of doses
administered in the civilian non-institutionalized population
Moderate increase in childrenrsquos coverage since 2009
large increases since 2008
Similar coverage for adults as for 2009-10 trivalent
Coverage among adults ge65 years declining past two seasons
Racialethnic disparities among all adults persist
Non-Hispanic white adults significantly higher levels
Children nH-whites did not have higher coverage vs
other racialethnic groups in 2010-11
Wide variations among states
Maintained last seasonrsquos increases for pregnant women
and healthcare personnel 16
Limitations Self-reported vaccination not validated by medical records
Survey estimates may not be representative
BRFSS does not reach households with only cell phones (will do so next year)
Telephone survey response rates low
Representativeness of internet panel survey estimates needs further evaluation
Tracking trends by season complicated by multiple data sources
with different timeliness and possibly validity
Comparisons to 2009-10 season estimates complicated by unique
circumstances of pandemic and persons could have received
either 2009 H1N1 vaccine only seasonal vaccine only or both
17
Vaccination in the 2010-11 Influenza Season What did the US achieve
bull Despite the expected challenge of ldquoflu fatiguerdquo overallcopyvaccine coverage maintained last seasonrsquos increasescopyndash Significant increases in Hispanic and non-Hispanic black children
bull Multiple venues were accessed for vaccination
bull Challenges for the coming season
ndash Maintain the gains
ndash Improve vaccination coverage among adults with risk conditions
and older adults
ndash Improve full vaccination of children recommended for two doses
18
Source Biologics data
166-173m projected for 2011-12 (592011)
0
20
40
60
80
100
120
140
160
180 Ju
ly w
k 1
wk
2
wk
3
wk
4
Au
gu
st w
k 1
wk
2
wk
3
wk
4
Sep
tem
ber
wk
1
wk
2
wk
3
wk
4
Oct
ob
er w
k 1
wk
2
wk
3
wk
4
No
vem
ber
wk
1
wk
2
wk
3
wk
4
Dec
emb
er w
k 1
wk
2
wk
3
wk
4
Jan
ua
ry w
k 1
wk
2
wk
3
wk
4
Feb
rua
ry w
k 1
wk
2
wk
3
wk
4 C
um
ula
tiv
e n
um
be
r o
f d
ose
s d
istr
ibu
ted
in
mil
lio
ns
Month
Cumulative doses of influenza vaccines distributed by month 2004-05 -- 2011-12 seasons US
2011-12
2010-11
2009-10
2008-09
2007-08
2006-07
2005-06
2004-05
asymp1155m by 10072011
19
2011-12 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2011 and March or April 2012
bull National Flu Survey (NFS) November 2011 and March 2012
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
20
Preliminary Influenza Vaccination Coverage in Children 6mo-17yrs 2011-12 Season
Estimated coverage by October 15 2011 22-32
Higher than 17-20 by this date last season
Intended vaccination for children
44 to 56 already have or ldquodefinitely willrdquo be vaccinated
bull Consistent with 2010-11 coverage by end of May 2011 (51)
bull Adult estimates not yet available from the Behavioral Risk Factor Surveillance System (BRFSS)
bull Child estimates from the National Immunization Survey with vaccinations reported by parentsguardians without
provider confirmation Estimated coverage based on interviews conducted 912011-1082011 Projected coverage
including ldquodefinite intentrdquo based on interviews conducted 1012011-1082011 (n=2135)
21
Upcoming Data Releases
bull National Influenza Vaccination Week
(NIVW ) December 4-10 2011
ndash CDC media briefing Dec 5
bull Results from November 2011
ndash National Flu Survey
ndash Panel surveys
raquo Pregnant women
raquo Health Care Personnel
bull Monthly estimates for children and adults from NIS and BRFSS (schedule to be determined)
22
FluVaxView CDC Source for Influenza Vaccination Coverage Data
httpwwwcdcgovfluprofessionalsvaccinationvaccinecoveragehtm 23
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Place of Influenza Vaccination Among Adults ndashlaquoUnited States 2010-11 Season
MMWR June 17 2011
Doctorrsquos office is most important medical setting
Workplace and store important non-medical settings
Increase in store vaccination (184) compared to
1998-99 (5) and 2006-07 (7)
Increases in persons vaccinated since 2006-07
Doctorrsquos office 28 million (2006-07) to 37 million (2010-11)
Store 6 million (2006-07) to 17 million (2010-11)
vaccinated in non-medical settings higher for
whites (44) vs blacks (29) Hispanics (34)
Attended college (47) vs lt high school education (28)
15
Summary 44 million more seasonal (trivalent) influenza vaccine
doses distributed than in 2009-10 Coverage levels by census population estimates can provide estimates of doses
administered in the civilian non-institutionalized population
Moderate increase in childrenrsquos coverage since 2009
large increases since 2008
Similar coverage for adults as for 2009-10 trivalent
Coverage among adults ge65 years declining past two seasons
Racialethnic disparities among all adults persist
Non-Hispanic white adults significantly higher levels
Children nH-whites did not have higher coverage vs
other racialethnic groups in 2010-11
Wide variations among states
Maintained last seasonrsquos increases for pregnant women
and healthcare personnel 16
Limitations Self-reported vaccination not validated by medical records
Survey estimates may not be representative
BRFSS does not reach households with only cell phones (will do so next year)
Telephone survey response rates low
Representativeness of internet panel survey estimates needs further evaluation
Tracking trends by season complicated by multiple data sources
with different timeliness and possibly validity
Comparisons to 2009-10 season estimates complicated by unique
circumstances of pandemic and persons could have received
either 2009 H1N1 vaccine only seasonal vaccine only or both
17
Vaccination in the 2010-11 Influenza Season What did the US achieve
bull Despite the expected challenge of ldquoflu fatiguerdquo overallcopyvaccine coverage maintained last seasonrsquos increasescopyndash Significant increases in Hispanic and non-Hispanic black children
bull Multiple venues were accessed for vaccination
bull Challenges for the coming season
ndash Maintain the gains
ndash Improve vaccination coverage among adults with risk conditions
and older adults
ndash Improve full vaccination of children recommended for two doses
18
Source Biologics data
166-173m projected for 2011-12 (592011)
0
20
40
60
80
100
120
140
160
180 Ju
ly w
k 1
wk
2
wk
3
wk
4
Au
gu
st w
k 1
wk
2
wk
3
wk
4
Sep
tem
ber
wk
1
wk
2
wk
3
wk
4
Oct
ob
er w
k 1
wk
2
wk
3
wk
4
No
vem
ber
wk
1
wk
2
wk
3
wk
4
Dec
emb
er w
k 1
wk
2
wk
3
wk
4
Jan
ua
ry w
k 1
wk
2
wk
3
wk
4
Feb
rua
ry w
k 1
wk
2
wk
3
wk
4 C
um
ula
tiv
e n
um
be
r o
f d
ose
s d
istr
ibu
ted
in
mil
lio
ns
Month
Cumulative doses of influenza vaccines distributed by month 2004-05 -- 2011-12 seasons US
2011-12
2010-11
2009-10
2008-09
2007-08
2006-07
2005-06
2004-05
asymp1155m by 10072011
19
2011-12 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2011 and March or April 2012
bull National Flu Survey (NFS) November 2011 and March 2012
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
20
Preliminary Influenza Vaccination Coverage in Children 6mo-17yrs 2011-12 Season
Estimated coverage by October 15 2011 22-32
Higher than 17-20 by this date last season
Intended vaccination for children
44 to 56 already have or ldquodefinitely willrdquo be vaccinated
bull Consistent with 2010-11 coverage by end of May 2011 (51)
bull Adult estimates not yet available from the Behavioral Risk Factor Surveillance System (BRFSS)
bull Child estimates from the National Immunization Survey with vaccinations reported by parentsguardians without
provider confirmation Estimated coverage based on interviews conducted 912011-1082011 Projected coverage
including ldquodefinite intentrdquo based on interviews conducted 1012011-1082011 (n=2135)
21
Upcoming Data Releases
bull National Influenza Vaccination Week
(NIVW ) December 4-10 2011
ndash CDC media briefing Dec 5
bull Results from November 2011
ndash National Flu Survey
ndash Panel surveys
raquo Pregnant women
raquo Health Care Personnel
bull Monthly estimates for children and adults from NIS and BRFSS (schedule to be determined)
22
FluVaxView CDC Source for Influenza Vaccination Coverage Data
httpwwwcdcgovfluprofessionalsvaccinationvaccinecoveragehtm 23
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Summary 44 million more seasonal (trivalent) influenza vaccine
doses distributed than in 2009-10 Coverage levels by census population estimates can provide estimates of doses
administered in the civilian non-institutionalized population
Moderate increase in childrenrsquos coverage since 2009
large increases since 2008
Similar coverage for adults as for 2009-10 trivalent
Coverage among adults ge65 years declining past two seasons
Racialethnic disparities among all adults persist
Non-Hispanic white adults significantly higher levels
Children nH-whites did not have higher coverage vs
other racialethnic groups in 2010-11
Wide variations among states
Maintained last seasonrsquos increases for pregnant women
and healthcare personnel 16
Limitations Self-reported vaccination not validated by medical records
Survey estimates may not be representative
BRFSS does not reach households with only cell phones (will do so next year)
Telephone survey response rates low
Representativeness of internet panel survey estimates needs further evaluation
Tracking trends by season complicated by multiple data sources
with different timeliness and possibly validity
Comparisons to 2009-10 season estimates complicated by unique
circumstances of pandemic and persons could have received
either 2009 H1N1 vaccine only seasonal vaccine only or both
17
Vaccination in the 2010-11 Influenza Season What did the US achieve
bull Despite the expected challenge of ldquoflu fatiguerdquo overallcopyvaccine coverage maintained last seasonrsquos increasescopyndash Significant increases in Hispanic and non-Hispanic black children
bull Multiple venues were accessed for vaccination
bull Challenges for the coming season
ndash Maintain the gains
ndash Improve vaccination coverage among adults with risk conditions
and older adults
ndash Improve full vaccination of children recommended for two doses
18
Source Biologics data
166-173m projected for 2011-12 (592011)
0
20
40
60
80
100
120
140
160
180 Ju
ly w
k 1
wk
2
wk
3
wk
4
Au
gu
st w
k 1
wk
2
wk
3
wk
4
Sep
tem
ber
wk
1
wk
2
wk
3
wk
4
Oct
ob
er w
k 1
wk
2
wk
3
wk
4
No
vem
ber
wk
1
wk
2
wk
3
wk
4
Dec
emb
er w
k 1
wk
2
wk
3
wk
4
Jan
ua
ry w
k 1
wk
2
wk
3
wk
4
Feb
rua
ry w
k 1
wk
2
wk
3
wk
4 C
um
ula
tiv
e n
um
be
r o
f d
ose
s d
istr
ibu
ted
in
mil
lio
ns
Month
Cumulative doses of influenza vaccines distributed by month 2004-05 -- 2011-12 seasons US
2011-12
2010-11
2009-10
2008-09
2007-08
2006-07
2005-06
2004-05
asymp1155m by 10072011
19
2011-12 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2011 and March or April 2012
bull National Flu Survey (NFS) November 2011 and March 2012
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
20
Preliminary Influenza Vaccination Coverage in Children 6mo-17yrs 2011-12 Season
Estimated coverage by October 15 2011 22-32
Higher than 17-20 by this date last season
Intended vaccination for children
44 to 56 already have or ldquodefinitely willrdquo be vaccinated
bull Consistent with 2010-11 coverage by end of May 2011 (51)
bull Adult estimates not yet available from the Behavioral Risk Factor Surveillance System (BRFSS)
bull Child estimates from the National Immunization Survey with vaccinations reported by parentsguardians without
provider confirmation Estimated coverage based on interviews conducted 912011-1082011 Projected coverage
including ldquodefinite intentrdquo based on interviews conducted 1012011-1082011 (n=2135)
21
Upcoming Data Releases
bull National Influenza Vaccination Week
(NIVW ) December 4-10 2011
ndash CDC media briefing Dec 5
bull Results from November 2011
ndash National Flu Survey
ndash Panel surveys
raquo Pregnant women
raquo Health Care Personnel
bull Monthly estimates for children and adults from NIS and BRFSS (schedule to be determined)
22
FluVaxView CDC Source for Influenza Vaccination Coverage Data
httpwwwcdcgovfluprofessionalsvaccinationvaccinecoveragehtm 23
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Limitations Self-reported vaccination not validated by medical records
Survey estimates may not be representative
BRFSS does not reach households with only cell phones (will do so next year)
Telephone survey response rates low
Representativeness of internet panel survey estimates needs further evaluation
Tracking trends by season complicated by multiple data sources
with different timeliness and possibly validity
Comparisons to 2009-10 season estimates complicated by unique
circumstances of pandemic and persons could have received
either 2009 H1N1 vaccine only seasonal vaccine only or both
17
Vaccination in the 2010-11 Influenza Season What did the US achieve
bull Despite the expected challenge of ldquoflu fatiguerdquo overallcopyvaccine coverage maintained last seasonrsquos increasescopyndash Significant increases in Hispanic and non-Hispanic black children
bull Multiple venues were accessed for vaccination
bull Challenges for the coming season
ndash Maintain the gains
ndash Improve vaccination coverage among adults with risk conditions
and older adults
ndash Improve full vaccination of children recommended for two doses
18
Source Biologics data
166-173m projected for 2011-12 (592011)
0
20
40
60
80
100
120
140
160
180 Ju
ly w
k 1
wk
2
wk
3
wk
4
Au
gu
st w
k 1
wk
2
wk
3
wk
4
Sep
tem
ber
wk
1
wk
2
wk
3
wk
4
Oct
ob
er w
k 1
wk
2
wk
3
wk
4
No
vem
ber
wk
1
wk
2
wk
3
wk
4
Dec
emb
er w
k 1
wk
2
wk
3
wk
4
Jan
ua
ry w
k 1
wk
2
wk
3
wk
4
Feb
rua
ry w
k 1
wk
2
wk
3
wk
4 C
um
ula
tiv
e n
um
be
r o
f d
ose
s d
istr
ibu
ted
in
mil
lio
ns
Month
Cumulative doses of influenza vaccines distributed by month 2004-05 -- 2011-12 seasons US
2011-12
2010-11
2009-10
2008-09
2007-08
2006-07
2005-06
2004-05
asymp1155m by 10072011
19
2011-12 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2011 and March or April 2012
bull National Flu Survey (NFS) November 2011 and March 2012
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
20
Preliminary Influenza Vaccination Coverage in Children 6mo-17yrs 2011-12 Season
Estimated coverage by October 15 2011 22-32
Higher than 17-20 by this date last season
Intended vaccination for children
44 to 56 already have or ldquodefinitely willrdquo be vaccinated
bull Consistent with 2010-11 coverage by end of May 2011 (51)
bull Adult estimates not yet available from the Behavioral Risk Factor Surveillance System (BRFSS)
bull Child estimates from the National Immunization Survey with vaccinations reported by parentsguardians without
provider confirmation Estimated coverage based on interviews conducted 912011-1082011 Projected coverage
including ldquodefinite intentrdquo based on interviews conducted 1012011-1082011 (n=2135)
21
Upcoming Data Releases
bull National Influenza Vaccination Week
(NIVW ) December 4-10 2011
ndash CDC media briefing Dec 5
bull Results from November 2011
ndash National Flu Survey
ndash Panel surveys
raquo Pregnant women
raquo Health Care Personnel
bull Monthly estimates for children and adults from NIS and BRFSS (schedule to be determined)
22
FluVaxView CDC Source for Influenza Vaccination Coverage Data
httpwwwcdcgovfluprofessionalsvaccinationvaccinecoveragehtm 23
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Vaccination in the 2010-11 Influenza Season What did the US achieve
bull Despite the expected challenge of ldquoflu fatiguerdquo overallcopyvaccine coverage maintained last seasonrsquos increasescopyndash Significant increases in Hispanic and non-Hispanic black children
bull Multiple venues were accessed for vaccination
bull Challenges for the coming season
ndash Maintain the gains
ndash Improve vaccination coverage among adults with risk conditions
and older adults
ndash Improve full vaccination of children recommended for two doses
18
Source Biologics data
166-173m projected for 2011-12 (592011)
0
20
40
60
80
100
120
140
160
180 Ju
ly w
k 1
wk
2
wk
3
wk
4
Au
gu
st w
k 1
wk
2
wk
3
wk
4
Sep
tem
ber
wk
1
wk
2
wk
3
wk
4
Oct
ob
er w
k 1
wk
2
wk
3
wk
4
No
vem
ber
wk
1
wk
2
wk
3
wk
4
Dec
emb
er w
k 1
wk
2
wk
3
wk
4
Jan
ua
ry w
k 1
wk
2
wk
3
wk
4
Feb
rua
ry w
k 1
wk
2
wk
3
wk
4 C
um
ula
tiv
e n
um
be
r o
f d
ose
s d
istr
ibu
ted
in
mil
lio
ns
Month
Cumulative doses of influenza vaccines distributed by month 2004-05 -- 2011-12 seasons US
2011-12
2010-11
2009-10
2008-09
2007-08
2006-07
2005-06
2004-05
asymp1155m by 10072011
19
2011-12 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2011 and March or April 2012
bull National Flu Survey (NFS) November 2011 and March 2012
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
20
Preliminary Influenza Vaccination Coverage in Children 6mo-17yrs 2011-12 Season
Estimated coverage by October 15 2011 22-32
Higher than 17-20 by this date last season
Intended vaccination for children
44 to 56 already have or ldquodefinitely willrdquo be vaccinated
bull Consistent with 2010-11 coverage by end of May 2011 (51)
bull Adult estimates not yet available from the Behavioral Risk Factor Surveillance System (BRFSS)
bull Child estimates from the National Immunization Survey with vaccinations reported by parentsguardians without
provider confirmation Estimated coverage based on interviews conducted 912011-1082011 Projected coverage
including ldquodefinite intentrdquo based on interviews conducted 1012011-1082011 (n=2135)
21
Upcoming Data Releases
bull National Influenza Vaccination Week
(NIVW ) December 4-10 2011
ndash CDC media briefing Dec 5
bull Results from November 2011
ndash National Flu Survey
ndash Panel surveys
raquo Pregnant women
raquo Health Care Personnel
bull Monthly estimates for children and adults from NIS and BRFSS (schedule to be determined)
22
FluVaxView CDC Source for Influenza Vaccination Coverage Data
httpwwwcdcgovfluprofessionalsvaccinationvaccinecoveragehtm 23
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Source Biologics data
166-173m projected for 2011-12 (592011)
0
20
40
60
80
100
120
140
160
180 Ju
ly w
k 1
wk
2
wk
3
wk
4
Au
gu
st w
k 1
wk
2
wk
3
wk
4
Sep
tem
ber
wk
1
wk
2
wk
3
wk
4
Oct
ob
er w
k 1
wk
2
wk
3
wk
4
No
vem
ber
wk
1
wk
2
wk
3
wk
4
Dec
emb
er w
k 1
wk
2
wk
3
wk
4
Jan
ua
ry w
k 1
wk
2
wk
3
wk
4
Feb
rua
ry w
k 1
wk
2
wk
3
wk
4 C
um
ula
tiv
e n
um
be
r o
f d
ose
s d
istr
ibu
ted
in
mil
lio
ns
Month
Cumulative doses of influenza vaccines distributed by month 2004-05 -- 2011-12 seasons US
2011-12
2010-11
2009-10
2008-09
2007-08
2006-07
2005-06
2004-05
asymp1155m by 10072011
19
2011-12 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2011 and March or April 2012
bull National Flu Survey (NFS) November 2011 and March 2012
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
20
Preliminary Influenza Vaccination Coverage in Children 6mo-17yrs 2011-12 Season
Estimated coverage by October 15 2011 22-32
Higher than 17-20 by this date last season
Intended vaccination for children
44 to 56 already have or ldquodefinitely willrdquo be vaccinated
bull Consistent with 2010-11 coverage by end of May 2011 (51)
bull Adult estimates not yet available from the Behavioral Risk Factor Surveillance System (BRFSS)
bull Child estimates from the National Immunization Survey with vaccinations reported by parentsguardians without
provider confirmation Estimated coverage based on interviews conducted 912011-1082011 Projected coverage
including ldquodefinite intentrdquo based on interviews conducted 1012011-1082011 (n=2135)
21
Upcoming Data Releases
bull National Influenza Vaccination Week
(NIVW ) December 4-10 2011
ndash CDC media briefing Dec 5
bull Results from November 2011
ndash National Flu Survey
ndash Panel surveys
raquo Pregnant women
raquo Health Care Personnel
bull Monthly estimates for children and adults from NIS and BRFSS (schedule to be determined)
22
FluVaxView CDC Source for Influenza Vaccination Coverage Data
httpwwwcdcgovfluprofessionalsvaccinationvaccinecoveragehtm 23
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
2011-12 Vaccination Data Sources
bull National Immunization Survey (NIS) (for children)
bull Behavioral Risk Factor Surveillance System (BRFSS) (for adults)
bull Internet Panel Surveys for health care personnel and pregnant women November 2011 and March or April 2012
bull National Flu Survey (NFS) November 2011 and March 2012
bull National Health Interview Survey (NHIS)
bull Pregnancy Risk Assessment Monitoring System (PRAMS)
bull Vaccinations administered in physician offices (claims data)
bull CMS Minimum Data Set (nursing home residents)
20
Preliminary Influenza Vaccination Coverage in Children 6mo-17yrs 2011-12 Season
Estimated coverage by October 15 2011 22-32
Higher than 17-20 by this date last season
Intended vaccination for children
44 to 56 already have or ldquodefinitely willrdquo be vaccinated
bull Consistent with 2010-11 coverage by end of May 2011 (51)
bull Adult estimates not yet available from the Behavioral Risk Factor Surveillance System (BRFSS)
bull Child estimates from the National Immunization Survey with vaccinations reported by parentsguardians without
provider confirmation Estimated coverage based on interviews conducted 912011-1082011 Projected coverage
including ldquodefinite intentrdquo based on interviews conducted 1012011-1082011 (n=2135)
21
Upcoming Data Releases
bull National Influenza Vaccination Week
(NIVW ) December 4-10 2011
ndash CDC media briefing Dec 5
bull Results from November 2011
ndash National Flu Survey
ndash Panel surveys
raquo Pregnant women
raquo Health Care Personnel
bull Monthly estimates for children and adults from NIS and BRFSS (schedule to be determined)
22
FluVaxView CDC Source for Influenza Vaccination Coverage Data
httpwwwcdcgovfluprofessionalsvaccinationvaccinecoveragehtm 23
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Preliminary Influenza Vaccination Coverage in Children 6mo-17yrs 2011-12 Season
Estimated coverage by October 15 2011 22-32
Higher than 17-20 by this date last season
Intended vaccination for children
44 to 56 already have or ldquodefinitely willrdquo be vaccinated
bull Consistent with 2010-11 coverage by end of May 2011 (51)
bull Adult estimates not yet available from the Behavioral Risk Factor Surveillance System (BRFSS)
bull Child estimates from the National Immunization Survey with vaccinations reported by parentsguardians without
provider confirmation Estimated coverage based on interviews conducted 912011-1082011 Projected coverage
including ldquodefinite intentrdquo based on interviews conducted 1012011-1082011 (n=2135)
21
Upcoming Data Releases
bull National Influenza Vaccination Week
(NIVW ) December 4-10 2011
ndash CDC media briefing Dec 5
bull Results from November 2011
ndash National Flu Survey
ndash Panel surveys
raquo Pregnant women
raquo Health Care Personnel
bull Monthly estimates for children and adults from NIS and BRFSS (schedule to be determined)
22
FluVaxView CDC Source for Influenza Vaccination Coverage Data
httpwwwcdcgovfluprofessionalsvaccinationvaccinecoveragehtm 23
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Upcoming Data Releases
bull National Influenza Vaccination Week
(NIVW ) December 4-10 2011
ndash CDC media briefing Dec 5
bull Results from November 2011
ndash National Flu Survey
ndash Panel surveys
raquo Pregnant women
raquo Health Care Personnel
bull Monthly estimates for children and adults from NIS and BRFSS (schedule to be determined)
22
FluVaxView CDC Source for Influenza Vaccination Coverage Data
httpwwwcdcgovfluprofessionalsvaccinationvaccinecoveragehtm 23
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
FluVaxView CDC Source for Influenza Vaccination Coverage Data
httpwwwcdcgovfluprofessionalsvaccinationvaccinecoveragehtm 23
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Thank You
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE Atlanta GA 30333
Telephone 1-800-CDC-INFO (232-4636)TTY 1-888-232-6348
E-mail cdcinfocdcgov Web wwwcdcgov
National Center for Immunization and Respiratory Diseases
Immunization Services Division 24
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Two-dose influenza vaccination coverage for children lt9 years 2010-11 season
Age on 1112010 6-11
mo
1 yr 2 yr 3 yr 4 yr 5 yr 6 yr 7 yr 8 yr
with ge1 dose 690 628 518 622 615 602 570 548 533
with ge2 doses 328 217 128 121 116 125 79 103 96
overall
with ge2 doses 475 345 246 194 189 207 139 189 180
among those with ge1
dose
bull From the September 2010 ndash June 2011 National Immunization Survey receipt of two or
more influenza vaccinations by end of May 2011 as reported by parentsguardians
without provider confirmation prior season vaccinations not ascertained
bull Coverage with two or more doses will underestimate fully vaccinated coverage because
some older children may have received influenza vaccinations in prior seasons and need
only one 2010-11 season vaccination to be fully vaccinated Of children 6-11 months as
of 1112010 none were age-eligible for influenza vaccination as of 312010 for prior
season vaccination of children 12-23 months as of 1112010 asymp 7 out of 12 were ge6
months old as of 1212009
25
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Seasonal (Trivalent) Influenza Vaccination Trends by Age Group BRFSS and NHFS (2009-10)
Co
ve
rag
e E
stim
ate
(
) 100 90 80 70 60 50 40 30 20 10
0 2007-08 2008-09 2009-10 2010-11
ge65 yrs
50minus64 yrs
18minus49 yrs
Influenza Season 26
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Seasonal (Trivalent) Influenza Vaccination Trends for Persons 18-49 yrs BRFSS and NHFS (2009-10)
100 90
Co
ve
rag
e E
stim
ate
(
)
80 70 60 50 40 30 20 10
0
18minus49 yrs at High Risk
18minus49 yrs
2007-08 2008-09 2009-10 2010-11
Influenza Season Selected high-risk conditions limited to people with asthma
diabetes or heart disease
27
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Influenza Vaccination Coverage by State Children 6mo-17 years 2010-11 Season
Source National Immunization Survey September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
28
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Influenza Vaccination Coverage by State Adults ge18 years 2010-11 Season
Source Behavioral Risk Factor Surveillance System September 2010-June 2011
Online at httpwwwcdcgovfluprofessionalsvaccinationreporti1011reportI
29
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30
Influenza vaccination coverage for adults aged ge65 years by
raceethnicity---Behavioral Risk Factor Surveillance System (BRFSS)
United States 2000--2010 (MMWR Supplement January 14 2011 60(01)38-41)
30